How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $190.55 | Professional | None | $93.33 | $128.82 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | None | $95.50 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $123.03 Typical High $223.87 | Facility | None | $50.12 | $123.03 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $239.88 | Professional | None | $89.13 | $147.91 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $389.05 | Professional | None | $169.82 | $204.17 | $389.05 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $309.03 | Professional | None | $83.18 | $147.91 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $288.40 | Professional | None | $147.91 | $147.91 | $288.40 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $47.86 Typical High $95.50 | Professional | 52 · Reduced service | $46.77 | $47.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.05 Typical High $38.02 | Professional | 53 · Discontinued | $18.62 | $19.05 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $141.25 | Professional | 54 · Surgery only | $70.79 | $70.79 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $28.18 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.55 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.33 | $9.55 | $19.05 |
Where Maryland sits
The same service costs 3.3 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 51st of 51
$120
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.