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 $169.82 Median $234.42 Typical High $389.05 | Professional | None | $169.82 | $234.42 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | None | $147.91 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $870.96 Typical High $1,548.82 | Facility | None | $331.13 | $870.96 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $562.34 | Professional | None | $162.18 | $309.03 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $562.34 | Professional | None | $331.13 | $380.19 | $562.34 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $602.56 | Professional | None | $147.91 | $316.23 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $512.86 | Professional | None | $239.88 | $239.88 | $512.86 |
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 $85.11 Median $117.49 Typical High $194.98 | Professional | 52 · Reduced service | $85.11 | $117.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $46.77 Typical High $77.62 | Professional | 53 · Discontinued | $33.88 | $46.77 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $288.40 | Professional | 54 · Surgery only | $128.82 | $173.78 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $57.54 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.98 | $23.44 | $38.90 |
Where Maryland sits
The same service costs 3.9 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· 32nd of 51
$331
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.