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 $102.33 Median $144.54 Typical High $239.88 | Professional | None | $102.33 | $144.54 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $123.03 | Professional | None | $100.00 | $112.20 | $123.03 |
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 $100.00 Median $138.04 Typical High $257.04 | Professional | None | $100.00 | $138.04 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $323.59 | Professional | None | $141.25 | $169.82 | $323.59 |
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 $97.72 Median $162.18 Typical High $295.12 | Professional | None | $97.72 | $162.18 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $234.42 | Professional | None | $177.83 | $181.97 | $234.42 |
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 $51.29 Median $56.23 Typical High $72.44 | Professional | 52 · Reduced service | $51.29 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.39 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $85.11 Typical High $109.65 | Professional | 54 · Surgery only | $77.62 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $21.88 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $14.45 |
Where Maryland sits
The same service costs 3.1 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· 50th of 51
$138
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.