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 $158.49 Median $239.88 Typical High $295.12 | Professional | None | $158.49 | $239.88 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | None | $128.82 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $158.49 Typical High $263.03 | Facility | None | $50.12 | $158.49 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $407.38 | Professional | None | $144.54 | $239.88 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $562.34 | Professional | None | $338.84 | $380.19 | $562.34 |
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 $125.89 Median $213.80 Typical High $478.63 | Professional | None | $125.89 | $213.80 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $524.81 | Professional | None | $229.09 | $229.09 | $524.81 |
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 $79.43 Median $93.33 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $93.33 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $37.15 Typical High $58.88 | Professional | 53 · Discontinued | $31.62 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $141.25 Typical High $223.87 | Professional | 54 · Surgery only | $120.23 | $141.25 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $28.18 Typical High $44.67 | Professional | 55 · Aftercare only | $23.99 | $28.18 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.62 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.85 | $18.62 | $29.51 |
Where Maryland sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 51st of 51
$182
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.