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 Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $588.84 | Facility | None | $257.04 | $257.04 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $338.84 | Professional | None | $128.82 | $257.04 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $147.91 | Professional | None | $123.03 | $138.04 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $1,548.82 | Facility | None | $446.68 | $851.14 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $269.15 Typical High $489.78 | Professional | None | $120.23 | $269.15 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $501.19 | Professional | None | $263.03 | $331.13 | $501.19 |
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 $109.65 Median $251.19 Typical High $549.54 | Professional | None | $109.65 | $251.19 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $446.68 | Professional | None | $213.80 | $213.80 | $446.68 |
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 $64.57 Median $87.10 Typical High $169.82 | Professional | 52 · Reduced service | $64.57 | $87.10 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $34.67 Typical High $67.61 | Professional | 53 · Discontinued | $25.70 | $34.67 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $131.83 Typical High $251.19 | Professional | 54 · Surgery only | $95.50 | $131.83 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.30 Typical High $50.12 | Professional | 55 · Aftercare only | $19.05 | $26.30 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.38 Typical High $33.88 | Professional | 56 · Pre-op care only | $12.88 | $17.38 | $33.88 |
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· 27th of 51
$288
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.