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 $117.49 Median $144.54 Typical High $234.42 | Facility | None | $117.49 | $144.54 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | None | $117.49 | $123.03 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | None | $144.54 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $7,079.46 | Facility | None | $489.78 | $602.56 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $208.93 | Professional | None | $102.33 | $117.49 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $208.93 | Professional | None | $123.03 | $138.04 | $208.93 |
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 $95.50 Median $112.20 Typical High $257.04 | Professional | None | $95.50 | $112.20 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $58.88 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $23.44 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | 54 · Surgery only | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.30 |
Where Maryland sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 44th of 51
$132
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.