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 $181.97 Median $181.97 Typical High $186.21 | Professional | None | $181.97 | $181.97 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | None | $186.21 | $208.93 | $208.93 |
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 $162.18 Median $177.83 Typical High $331.13 | Professional | None | $162.18 | $177.83 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $323.59 | Professional | None | $169.82 | $194.98 | $323.59 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $398.11 | Professional | None | $147.91 | $173.78 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $257.04 | Professional | None | $173.78 | $173.78 | $257.04 |
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 $91.20 Median $91.20 Typical High $93.33 | Professional | 52 · Reduced service | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $37.15 | Professional | 53 · Discontinued | $36.31 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 54 · Surgery only | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.62 |
Where Maryland sits
The same service costs 4.6 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
$186
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.