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 $100.00 Median $933.25 Typical High $1,819.70 | Professional | None | $100.00 | $933.25 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $123.03 | Professional | None | $102.33 | $114.82 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $2,691.53 | Facility | None | $489.78 | $616.60 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $302.00 Typical High $2,137.96 | Professional | None | $93.33 | $302.00 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,479.11 | $2,398.83 |
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 $95.50 Median $1,023.29 Typical High $2,630.27 | Professional | None | $95.50 | $1,023.29 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,047.13 | $1,949.84 |
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 $50.12 Median $467.74 Typical High $691.83 | Professional | 52 · Reduced service | $50.12 | $467.74 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $186.21 Typical High $275.42 | Professional | 53 · Discontinued | $19.95 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $707.95 Typical High $1,047.13 | Professional | 54 · Surgery only | $75.86 | $707.95 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $141.25 Typical High $208.93 | Professional | 55 · Aftercare only | $15.14 | $141.25 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $93.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $10.00 | $93.33 | $138.04 |
Where Maryland sits
The same service costs 9.5 times more in Washington than in Nebraska. 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· 49th of 51
$209
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.