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 $389.05 Median $389.05 Typical High $407.38 | Professional | None | $389.05 | $389.05 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | None | $562.34 | $616.60 | $616.60 |
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 $338.84 Median $389.05 Typical High $707.95 | Professional | None | $338.84 | $389.05 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $691.83 | Professional | None | $380.19 | $426.58 | $691.83 |
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 $281.84 Median $371.54 Typical High $831.76 | Professional | None | $281.84 | $371.54 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $194.98 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $40.74 |
Where Maryland sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 45th of 51
$407
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.