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 $275.42 Typical High $426.58 | Professional | None | $169.82 | $275.42 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | None | $162.18 | $181.97 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $851.14 Typical High $1,513.56 | Facility | None | $331.13 | $851.14 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $512.86 | Professional | None | $162.18 | $263.03 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $457.09 | Professional | None | $269.15 | $316.23 | $457.09 |
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 $281.84 Typical High $512.86 | Professional | None | $147.91 | $281.84 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $416.87 | Professional | None | $199.53 | $199.53 | $416.87 |
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 $97.72 Typical High $154.88 | Professional | 52 · Reduced service | $85.11 | $97.72 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.90 Typical High $61.66 | Professional | 53 · Discontinued | $34.67 | $38.90 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $147.91 Typical High $229.09 | Professional | 54 · Surgery only | $128.82 | $147.91 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $29.51 Typical High $45.71 | Professional | 55 · Aftercare only | $25.70 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.50 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.38 | $19.50 | $30.90 |
Where Maryland sits
The same service costs 3.4 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· 35th of 51
$282
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.