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 $91.20 Median $134.90 Typical High $147.91 | Professional | None | $91.20 | $134.90 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $588.84 | Facility | None | $74.13 | $117.49 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $208.93 | Professional | None | $85.11 | $131.83 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $295.12 | Professional | None | $141.25 | $173.78 | $295.12 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $251.19 | Professional | None | $85.11 | $131.83 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $239.88 | Professional | None | $112.20 | $112.20 | $239.88 |
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 $45.71 Median $45.71 Typical High $74.13 | Professional | 52 · Reduced service | $45.71 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $29.51 | Professional | 53 · Discontinued | $18.20 | $18.62 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $112.20 | Professional | 54 · Surgery only | $69.18 | $69.18 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $22.39 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $14.79 |
Where Maryland sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$123
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.