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 $30.90 Median $83.18 Typical High $154.88 | Professional | None | $30.90 | $83.18 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $32.36 | Professional | None | $29.51 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $436.52 | Facility | None | $125.89 | $204.17 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $89.13 Typical High $173.78 | Professional | None | $29.51 | $89.13 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $275.42 | Professional | None | $173.78 | $204.17 | $275.42 |
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 $25.12 Median $70.79 Typical High $199.53 | Professional | None | $25.12 | $70.79 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $288.40 | Professional | None | $85.11 | $85.11 | $288.40 |
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 $15.49 Median $20.89 Typical High $77.62 | Professional | 52 · Reduced service | $15.49 | $20.89 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $8.51 Typical High $30.90 | Professional | 53 · Discontinued | $6.17 | $8.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $31.62 Typical High $117.49 | Professional | 54 · Surgery only | $22.91 | $31.62 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $6.31 Typical High $23.44 | Professional | 55 · Aftercare only | $4.57 | $6.31 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $8.32 Typical High $15.49 | Professional | 56 · Pre-op care only | $3.09 | $8.32 | $15.49 |
Where Maryland sits
The same service costs 5.8 times more in Alaska than in Virginia. 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
$70.79
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.