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 $120.23 Median $162.18 Typical High $269.15 | Professional | None | $120.23 | $162.18 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | None | $114.82 | $125.89 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $436.52 | Facility | None | $199.53 | $316.23 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $389.05 | Professional | None | $112.20 | $213.80 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $398.11 | Professional | None | $234.42 | $281.84 | $398.11 |
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 $102.33 Median $218.78 Typical High $416.87 | Professional | None | $102.33 | $218.78 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $380.19 | Professional | None | $147.91 | $147.91 | $380.19 |
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 $60.26 Median $81.28 Typical High $134.90 | Professional | 52 · Reduced service | $60.26 | $81.28 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $32.36 Typical High $53.70 | Professional | 53 · Discontinued | $23.99 | $32.36 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $120.23 Typical High $199.53 | Professional | 54 · Surgery only | $91.20 | $120.23 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.99 Typical High $39.81 | Professional | 55 · Aftercare only | $18.20 | $23.99 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $16.22 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.02 | $16.22 | $26.92 |
Where Maryland sits
The same service costs 3.2 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· 47th of 51
$200
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.