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 $245.47 Median $245.47 Typical High $251.19 | Professional | None | $245.47 | $245.47 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | None | $190.55 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $1,584.89 | Facility | None | $512.86 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $436.52 | Professional | None | $213.80 | $234.42 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $426.58 | Professional | None | $223.87 | $257.04 | $426.58 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $501.19 | Professional | None | $181.97 | $218.78 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $338.84 | Professional | None | $229.09 | $229.09 | $338.84 |
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 $120.23 Median $120.23 Typical High $123.03 | Professional | 52 · Reduced service | $120.23 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 53 · Discontinued | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | 54 · Surgery only | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $37.15 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $25.12 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $25.12 |
Where Maryland sits
The same service costs 5.0 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· 47th of 51
$234
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.