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 $54.95 Median $81.28 Typical High $97.72 | Professional | None | $54.95 | $81.28 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $61.66 | Professional | None | $52.48 | $58.88 | $61.66 |
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 $51.29 Median $85.11 Typical High $134.90 | Professional | None | $51.29 | $85.11 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $194.98 | Professional | None | $93.33 | $114.82 | $194.98 |
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 $51.29 Median $89.13 Typical High $169.82 | Professional | None | $51.29 | $89.13 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $158.49 | Professional | None | $75.86 | $75.86 | $158.49 |
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 $27.54 Median $27.54 Typical High $48.98 | Professional | 52 · Reduced service | $27.54 | $27.54 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $19.50 | Professional | 53 · Discontinued | $10.96 | $10.96 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $72.44 | Professional | 54 · Surgery only | $41.69 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $14.45 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $9.77 |
Where Maryland sits
The same service costs 3.2 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
$81.28
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.