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 $44.67 Median $51.29 Typical High $120.23 | Facility | None | $44.67 | $51.29 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $75.86 Typical High $104.71 | Professional | None | $37.15 | $75.86 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | None | $38.02 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $354.81 | Facility | None | $50.12 | $50.12 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $104.71 | Professional | None | $35.48 | $70.79 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $169.82 | Professional | None | $81.28 | $104.71 | $169.82 |
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 $31.62 Median $67.61 Typical High $144.54 | Professional | None | $31.62 | $67.61 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $151.36 | Professional | None | $63.10 | $63.10 | $151.36 |
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 $18.62 Median $19.05 Typical High $46.77 | Professional | 52 · Reduced service | $18.62 | $19.05 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $18.62 | Professional | 53 · Discontinued | $7.41 | $7.59 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $28.18 Typical High $69.18 | Professional | 54 · Surgery only | $28.18 | $28.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $13.80 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $9.33 |
Where Maryland sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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
$63.10
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.