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 $12.88 Median $26.92 Typical High $34.67 | Professional | None | $12.88 | $26.92 | $34.67 |
CareFirst Setting Professional Modifier None Typical Low $11.22 Median $12.30 Typical High $12.59 | Professional | None | $11.22 | $12.30 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $588.84 | Facility | None | $50.12 | $52.48 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $26.92 Typical High $40.74 | Professional | None | $13.18 | $26.92 | $40.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $67.61 | Professional | None | $31.62 | $38.90 | $67.61 |
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 $12.88 Median $26.92 Typical High $54.95 | Professional | None | $12.88 | $26.92 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $53.70 | Professional | None | $25.12 | $25.12 | $53.70 |
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 $6.46 Median $7.24 Typical High $15.49 | Professional | 52 · Reduced service | $6.46 | $7.24 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.88 Typical High $6.31 | Professional | 53 · Discontinued | $2.57 | $2.88 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $10.72 Typical High $23.44 | Professional | 54 · Surgery only | $9.77 | $10.72 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.14 Typical High $4.68 | Professional | 55 · Aftercare only | $1.95 | $2.14 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.95 Typical High $3.16 | Professional | 56 · Pre-op care only | $1.29 | $2.95 | $3.16 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 48th of 51
$26.92
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.