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 $20.89 Median $39.81 Typical High $54.95 | Professional | None | $20.89 | $39.81 | $54.95 |
CareFirst Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $20.42 | Professional | None | $17.78 | $19.95 | $20.42 |
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 $21.88 Median $36.31 Typical High $58.88 | Professional | None | $21.88 | $36.31 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $53.70 Typical High $93.33 | Professional | None | $43.65 | $53.70 | $93.33 |
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 $21.88 Median $38.90 Typical High $74.13 | Professional | None | $21.88 | $38.90 | $74.13 |
Wellpoint Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $74.13 | Professional | None | $35.48 | $35.48 | $74.13 |
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 $10.47 Median $11.75 Typical High $20.89 | Professional | 52 · Reduced service | $10.47 | $11.75 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.68 Typical High $8.32 | Professional | 53 · Discontinued | $4.17 | $4.68 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $17.78 Typical High $30.90 | Professional | 54 · Surgery only | $15.85 | $17.78 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.55 Typical High $6.31 | Professional | 55 · Aftercare only | $3.16 | $3.55 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $3.98 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.09 | $3.98 | $4.17 |
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· 47th of 51
$38.90
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.