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 $354.81 Median $363.08 Typical High $389.05 | Professional | None | $354.81 | $363.08 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | None | $302.00 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $602.56 | Facility | None | $120.23 | $194.98 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $758.58 | Professional | None | $239.88 | $338.84 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $575.44 | Professional | None | $323.59 | $363.08 | $575.44 |
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 $190.55 Median $354.81 Typical High $831.76 | Professional | None | $190.55 | $354.81 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $478.63 | Professional | None | $147.91 | $147.91 | $478.63 |
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 $177.83 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $263.03 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $38.90 |
Where Maryland sits
The same service costs 4.8 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· 44th 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.