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 $165.96 Typical High $177.83 | Professional | None | $91.20 | $165.96 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $89.13 | Professional | None | $77.62 | $87.10 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $190.55 | Facility | None | $50.12 | $112.20 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $239.88 | Professional | None | $91.20 | $162.18 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $338.84 | Professional | None | $204.17 | $251.19 | $338.84 |
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 $89.13 Median $162.18 Typical High $309.03 | Professional | None | $89.13 | $162.18 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $346.74 | Professional | None | $158.49 | $158.49 | $346.74 |
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 $46.77 Typical High $89.13 | Professional | 52 · Reduced service | $45.71 | $46.77 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.05 Typical High $35.48 | Professional | 53 · Discontinued | $18.62 | $19.05 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $70.79 Typical High $134.90 | Professional | 54 · Surgery only | $69.18 | $70.79 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $26.92 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $17.78 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $17.78 |
Where Maryland sits
The same service costs 3.3 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
$135
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.