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 $48.98 Median $69.18 Typical High $81.28 | Professional | None | $48.98 | $69.18 | $81.28 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $43.65 | Professional | None | $39.81 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $107.15 | Facility | None | $50.12 | $64.57 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $120.23 | Professional | None | $46.77 | $74.13 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $151.36 | Professional | None | $87.10 | $100.00 | $151.36 |
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 $38.02 Median $61.66 Typical High $141.25 | Professional | None | $38.02 | $61.66 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $138.04 | Professional | None | $64.57 | $64.57 | $138.04 |
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 $24.55 Median $32.36 Typical High $40.74 | Professional | 52 · Reduced service | $24.55 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.88 Typical High $16.60 | Professional | 53 · Discontinued | $9.77 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $47.86 Typical High $61.66 | Professional | 54 · Surgery only | $36.31 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.77 Typical High $12.30 | Professional | 55 · Aftercare only | $7.24 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.46 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.90 | $6.46 | $8.13 |
Where Maryland sits
The same service costs 3.6 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· 49th of 51
$60.26
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.