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 $181.97 Median $275.42 Typical High $416.87 | Professional | None | $181.97 | $275.42 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $213.80 | Professional | None | $154.88 | $173.78 | $213.80 |
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 $169.82 Median $275.42 Typical High $524.81 | Professional | None | $169.82 | $275.42 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $446.68 | Professional | None | $275.42 | $323.59 | $446.68 |
United Setting Facility Modifier None Typical Low $407.38 Median $707.95 Typical High $1,778.28 | Facility | None | $407.38 | $707.95 | $1,778.28 |
United Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $537.03 | Professional | None | $169.82 | $302.00 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $426.58 | Professional | None | $239.88 | $239.88 | $426.58 |
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 $89.13 Median $117.49 Typical High $154.88 | Professional | 52 · Reduced service | $89.13 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $36.31 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $134.90 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $45.71 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.44 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.20 | $23.44 | $30.90 |
Where Maryland sits
The same service costs 3.1 times more in Alaska than in New York. 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· 40th of 51
$295
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.