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 $24.55 Median $32.36 Typical High $37.15 | Professional | None | $24.55 | $32.36 | $37.15 |
CareFirst Setting Professional Modifier None Typical Low $23.44 Median $26.30 Typical High $26.30 | Professional | None | $23.44 | $26.30 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $2,691.53 | Facility | None | $331.13 | $537.03 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $30.90 Typical High $48.98 | Professional | None | $22.91 | $30.90 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $69.18 | Professional | None | $34.67 | $39.81 | $69.18 |
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 $22.91 Median $32.36 Typical High $66.07 | Professional | None | $22.91 | $32.36 | $66.07 |
Wellpoint Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $54.95 | Professional | None | $28.84 | $28.84 | $54.95 |
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 $12.30 Median $12.30 Typical High $16.22 | Professional | 52 · Reduced service | $12.30 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $6.61 | Professional | 53 · Discontinued | $4.90 | $5.01 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.62 Typical High $24.55 | Professional | 54 · Surgery only | $18.20 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.72 Typical High $4.90 | Professional | 55 · Aftercare only | $3.63 | $3.72 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $3.31 |
Where Maryland sits
The same service costs 3.5 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· 47th of 51
$30.90
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.