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 $69.18 Median $77.62 Typical High $107.15 | Professional | None | $69.18 | $77.62 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | None | $56.23 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $138.04 | Facility | None | $50.12 | $81.28 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $154.88 | Professional | None | $64.57 | $91.20 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $204.17 | Professional | None | $120.23 | $138.04 | $204.17 |
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 $51.29 Median $81.28 Typical High $186.21 | Professional | None | $51.29 | $81.28 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $190.55 | Professional | None | $79.43 | $79.43 | $190.55 |
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 $34.67 Median $38.90 Typical High $53.70 | Professional | 52 · Reduced service | $34.67 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.49 Typical High $21.38 | Professional | 53 · Discontinued | $13.80 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $58.88 Typical High $79.43 | Professional | 54 · Surgery only | $51.29 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $15.85 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.76 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.92 | $7.76 | $10.72 |
Where Maryland sits
The same service costs 3.8 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· 49th of 51
$77.62
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.