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 $141.25 Median $234.42 Typical High $239.88 | Professional | None | $141.25 | $234.42 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $134.90 | Professional | None | $117.49 | $131.83 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $165.96 Typical High $602.56 | Facility | None | $102.33 | $165.96 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $346.74 | Professional | None | $141.25 | $218.78 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $457.09 | Professional | None | $245.47 | $302.00 | $457.09 |
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 $134.90 Median $218.78 Typical High $416.87 | Professional | None | $134.90 | $218.78 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $416.87 | Professional | None | $229.09 | $229.09 | $416.87 |
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 $70.79 Median $72.44 Typical High $120.23 | Professional | 52 · Reduced service | $70.79 | $72.44 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.84 Typical High $47.86 | Professional | 53 · Discontinued | $28.18 | $28.84 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | 54 · Surgery only | $107.15 | $107.15 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.45 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.13 | $14.45 | $23.99 |
Where Maryland sits
The same service costs 3.2 times more in Alaska than in Maryland. 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· 51st of 51
$186
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.