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 $41.69 Median $245.47 Typical High $363.08 | Professional | None | $41.69 | $245.47 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | None | $47.86 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $251.19 Typical High $660.69 | Professional | None | $41.69 | $251.19 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $691.83 | Professional | None | $309.03 | $371.54 | $691.83 |
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 $40.74 Median $302.00 Typical High $794.33 | Professional | None | $40.74 | $302.00 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $489.78 | Professional | None | $302.00 | $302.00 | $489.78 |
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 $20.89 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $20.89 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $48.98 Typical High $66.07 | Professional | 53 · Discontinued | $8.32 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $30.90 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $6.31 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $4.17 | $30.90 | $33.11 |
Where Maryland sits
The same service costs 6.9 times more in Iowa 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· 47th of 51
$126
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.