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 $61.66 Median $107.15 Typical High $194.98 | Professional | None | $61.66 | $107.15 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | None | $53.70 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $426.58 | Facility | None | $50.12 | $50.12 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $128.82 Typical High $288.40 | Professional | None | $56.23 | $128.82 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $288.40 | Professional | None | $177.83 | $204.17 | $288.40 |
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 $53.70 Median $125.89 Typical High $295.12 | Professional | None | $53.70 | $125.89 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $275.42 | Professional | None | $75.86 | $75.86 | $275.42 |
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 $30.90 Median $40.74 Typical High $97.72 | Professional | 52 · Reduced service | $30.90 | $40.74 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.60 Typical High $39.81 | Professional | 53 · Discontinued | $12.30 | $16.60 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $61.66 Typical High $147.91 | Professional | 54 · Surgery only | $45.71 | $61.66 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.30 Typical High $29.51 | Professional | 55 · Aftercare only | $9.12 | $12.30 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.13 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.17 | $8.13 | $19.50 |
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· 44th of 51
$100
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.