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 $134.90 Median $165.96 Typical High $213.80 | Professional | None | $134.90 | $165.96 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | None | $131.83 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $457.09 Typical High $2,691.53 | Facility | None | $426.58 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $309.03 | Professional | None | $125.89 | $190.55 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $436.52 | Professional | None | $199.53 | $251.19 | $436.52 |
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 $123.03 Median $186.21 Typical High $363.08 | Professional | None | $123.03 | $186.21 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | None | $169.82 | $169.82 | $338.84 |
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 $67.61 Median $67.61 Typical High $107.15 | Professional | 52 · Reduced service | $67.61 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $102.33 Typical High $158.49 | Professional | 54 · Surgery only | $100.00 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.42 Typical High $31.62 | Professional | 55 · Aftercare only | $19.95 | $20.42 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $21.38 |
Where Maryland sits
The same service costs 3.7 times more in Alaska than in New Jersey. 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
$170
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.