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 $338.84 Median $346.74 Typical High $398.11 | Professional | None | $338.84 | $346.74 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $371.54 | Professional | None | $331.13 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $2,290.87 | Facility | None | $512.86 | $1,288.25 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $741.31 | Professional | None | $302.00 | $346.74 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $602.56 | Professional | None | $316.23 | $363.08 | $602.56 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $870.96 | Professional | None | $309.03 | $501.19 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $478.63 | Professional | None | $323.59 | $323.59 | $478.63 |
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 $169.82 Median $169.82 Typical High $173.78 | Professional | 52 · Reduced service | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $263.03 | Professional | 54 · Surgery only | $251.19 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $34.67 |
Where Maryland sits
The same service costs 4.7 times more in Alaska than in Utah. 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· 48th of 51
$372
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.