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 $158.49 Median $158.49 Typical High $323.59 | Facility | None | $158.49 | $158.49 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $173.78 | Professional | None | $79.43 | $162.18 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | None | $77.62 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $602.56 | Facility | None | $50.12 | $66.07 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $251.19 | Professional | None | $75.86 | $151.36 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $323.59 | Professional | None | $186.21 | $208.93 | $323.59 |
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 $57.54 Median $144.54 Typical High $295.12 | Professional | None | $57.54 | $144.54 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $288.40 | Professional | None | $169.82 | $169.82 | $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 $39.81 Median $67.61 Typical High $87.10 | Professional | 52 · Reduced service | $39.81 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $18.62 Typical High $34.67 | Professional | 53 · Discontinued | $16.22 | $18.62 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $70.79 Typical High $128.82 | Professional | 54 · Surgery only | $60.26 | $70.79 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.13 Typical High $25.70 | Professional | 55 · Aftercare only | $12.02 | $14.13 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.94 | $13.49 | $17.38 |
Where Maryland sits
The same service costs 3.9 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· 48th of 51
$123
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.