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 $81.28 Median $81.28 Typical High $87.10 | Professional | None | $81.28 | $81.28 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $89.13 | Professional | None | $74.13 | $83.18 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $5,248.07 | Facility | None | $489.78 | $794.33 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $190.55 | Professional | None | $70.79 | $87.10 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $128.82 | Professional | None | $81.28 | $93.33 | $128.82 |
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 $64.57 Median $102.33 Typical High $181.97 | Professional | None | $64.57 | $102.33 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $123.03 | Professional | None | $72.44 | $72.44 | $123.03 |
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 $39.81 Median $39.81 Typical High $43.65 | Professional | 52 · Reduced service | $39.81 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $17.38 | Professional | 53 · Discontinued | $16.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 54 · Surgery only | $60.26 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $8.71 |
Where Maryland sits
The same service costs 4.1 times more in Alaska than in New York. 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· 45th of 51
$87.10
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.