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 $16.22 Median $23.99 Typical High $30.90 | Professional | None | $16.22 | $23.99 | $30.90 |
CareFirst Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $17.78 | Professional | None | $16.22 | $17.78 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $588.84 Typical High $2,691.53 | Facility | None | $50.12 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $25.70 Typical High $52.48 | Professional | None | $15.85 | $25.70 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $70.79 | Professional | None | $30.20 | $37.15 | $70.79 |
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 $15.14 Median $35.48 Typical High $74.13 | Professional | None | $15.14 | $35.48 | $74.13 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $51.29 | Professional | None | $30.90 | $30.90 | $51.29 |
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 $8.13 Median $8.32 Typical High $15.49 | Professional | 52 · Reduced service | $8.13 | $8.32 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.31 Typical High $6.17 | Professional | 53 · Discontinued | $3.24 | $3.31 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $12.30 Typical High $23.44 | Professional | 54 · Surgery only | $12.02 | $12.30 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.51 Typical High $4.68 | Professional | 55 · Aftercare only | $2.40 | $2.51 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.66 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.62 | $1.66 | $3.09 |
Where Maryland sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 43rd of 51
$28.84
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.