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 $87.10 Median $245.47 Typical High $288.40 | Professional | None | $87.10 | $245.47 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | None | $87.10 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $426.58 Typical High $741.31 | Facility | None | $338.84 | $426.58 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $223.87 Typical High $363.08 | Professional | None | $85.11 | $223.87 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $512.86 | Professional | None | $281.84 | $323.59 | $512.86 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $70.79 Median $194.98 Typical High $467.74 | Professional | None | $70.79 | $194.98 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $467.74 | Professional | None | $234.42 | $234.42 | $467.74 |
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 $43.65 Median $58.88 Typical High $144.54 | Professional | 52 · Reduced service | $43.65 | $58.88 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $23.99 Typical High $57.54 | Professional | 53 · Discontinued | $17.38 | $23.99 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $89.13 Typical High $213.80 | Professional | 54 · Surgery only | $64.57 | $89.13 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.78 Typical High $42.66 | Professional | 55 · Aftercare only | $12.88 | $17.78 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.75 Typical High $28.84 | Professional | 56 · Pre-op care only | $8.71 | $11.75 | $28.84 |
Where Maryland sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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· 42nd of 51
$195
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.