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 Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $204.17 | Facility | None | $91.20 | $114.82 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $190.55 | Professional | None | $91.20 | $144.54 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | None | $85.11 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $147.91 Typical High $645.65 | Facility | None | $89.13 | $147.91 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $218.78 | Professional | None | $87.10 | $141.25 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $316.23 | Professional | None | $154.88 | $190.55 | $316.23 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $269.15 | Professional | None | $85.11 | $144.54 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $263.03 | Professional | None | $131.83 | $131.83 | $263.03 |
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 $45.71 Typical High $81.28 | Professional | 52 · Reduced service | $45.71 | $45.71 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $32.36 | Professional | 53 · Discontinued | $18.20 | $18.20 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $123.03 | Professional | 54 · Surgery only | $67.61 | $67.61 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $24.55 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $16.22 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $16.22 |
Where Maryland sits
The same service costs 3.2 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· 49th 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.