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 $1.95 Median $6.17 Typical High $8.13 | Professional | None | $1.95 | $6.17 | $8.13 |
CareFirst Setting Professional Modifier None Typical Low $2.00 Median $2.19 Typical High $3.89 | Professional | None | $2.00 | $2.19 | $3.89 |
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 $1.82 Median $5.37 Typical High $8.51 | Professional | None | $1.82 | $5.37 | $8.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.17 Median $7.76 Typical High $11.75 | Professional | None | $6.17 | $7.76 | $11.75 |
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 $1.91 Median $5.37 Typical High $10.96 | Professional | None | $1.91 | $5.37 | $10.96 |
Wellpoint Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $10.72 | Professional | None | $5.50 | $5.50 | $10.72 |
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 $0.98 Median $1.10 Typical High $3.55 | Professional | 52 · Reduced service | $0.98 | $1.10 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.43 Typical High $1.41 | Professional | 53 · Discontinued | $0.39 | $0.43 | $1.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.45 Median $1.62 Typical High $5.25 | Professional | 54 · Surgery only | $1.45 | $1.62 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.66 Typical High $1.07 | Professional | 55 · Aftercare only | $0.28 | $0.66 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.68 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.20 | $0.68 | $0.71 |
Where Maryland sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 42nd of 51
$5.62
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.