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 $177.83 Median $204.17 Typical High $316.23 | Professional | None | $177.83 | $204.17 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | None | $144.54 | $162.18 | $162.18 |
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 $165.96 Median $269.15 Typical High $457.09 | Professional | None | $165.96 | $269.15 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $602.56 | Professional | None | $354.81 | $407.38 | $602.56 |
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 $131.83 Median $213.80 Typical High $512.86 | Professional | None | $131.83 | $213.80 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $562.34 | Professional | None | $218.78 | $218.78 | $562.34 |
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 $89.13 Median $102.33 Typical High $158.49 | Professional | 52 · Reduced service | $89.13 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $63.10 | Professional | 53 · Discontinued | $35.48 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $239.88 | Professional | 54 · Surgery only | $134.90 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.90 Typical High $47.86 | Professional | 55 · Aftercare only | $26.92 | $30.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $31.62 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $31.62 |
Where Maryland sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 50th of 51
$186
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.