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 $134.90 Median $141.25 Typical High $141.25 | Professional | None | $134.90 | $141.25 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | None | $131.83 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $776.25 | Facility | None | $125.89 | $204.17 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $239.88 | Professional | None | $107.15 | $134.90 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $239.88 | Professional | None | $128.82 | $144.54 | $239.88 |
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 $102.33 Median $123.03 Typical High $275.42 | Professional | None | $102.33 | $123.03 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $199.53 | Professional | None | $114.82 | $114.82 | $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 $67.61 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $26.92 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $14.13 |
Where Maryland sits
The same service costs 5.6 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· 43rd of 51
$135
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.