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 $52.48 Median $81.28 Typical High $85.11 | Professional | None | $52.48 | $81.28 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $54.95 | Professional | None | $48.98 | $53.70 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $97.72 | Facility | None | $50.12 | $60.26 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $104.71 | Professional | None | $48.98 | $74.13 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $141.25 | Professional | None | $85.11 | $102.33 | $141.25 |
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 $43.65 Median $70.79 Typical High $141.25 | Professional | None | $43.65 | $70.79 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $144.54 | Professional | None | $61.66 | $61.66 | $144.54 |
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 $26.30 Median $26.30 Typical High $42.66 | Professional | 52 · Reduced service | $26.30 | $26.30 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $16.98 | Professional | 53 · Discontinued | $10.47 | $10.47 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $39.81 Typical High $63.10 | Professional | 54 · Surgery only | $38.90 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $12.59 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $8.51 |
Where Maryland sits
The same service costs 3.4 times more in Alaska than in New York. 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· 49th of 51
$64.57
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.