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 $114.82 Median $263.03 Typical High $446.68 | Professional | None | $114.82 | $263.03 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $114.82 | Professional | None | $97.72 | $109.65 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $109.65 Typical High $436.52 | Facility | None | $69.18 | $109.65 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $288.40 Typical High $645.65 | Professional | None | $107.15 | $288.40 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $660.69 | Professional | None | $363.08 | $489.78 | $660.69 |
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 $100.00 Median $263.03 Typical High $691.83 | Professional | None | $100.00 | $263.03 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $660.69 | Professional | None | $218.78 | $218.78 | $660.69 |
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 $57.54 Median $93.33 Typical High $223.87 | Professional | 52 · Reduced service | $57.54 | $93.33 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $37.15 Typical High $89.13 | Professional | 53 · Discontinued | $22.91 | $37.15 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $331.13 | Professional | 54 · Surgery only | $87.10 | $138.04 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $66.07 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.62 Typical High $44.67 | Professional | 56 · Pre-op care only | $11.48 | $18.62 | $44.67 |
Where Maryland sits
The same service costs 3.6 times more in Washington than in Arkansas. 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· 47th of 51
$174
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.