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 $93.33 Median $239.88 Typical High $512.86 | Professional | None | $93.33 | $239.88 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $109.65 | Professional | None | $89.13 | $100.00 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $436.52 Typical High $660.69 | Facility | None | $323.59 | $436.52 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $512.86 | Professional | None | $81.28 | $223.87 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $436.52 | Professional | None | $275.42 | $331.13 | $436.52 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $87.10 Median $218.78 Typical High $676.08 | Professional | None | $87.10 | $218.78 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $436.52 | Professional | None | $199.53 | $199.53 | $436.52 |
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 $46.77 Median $53.70 Typical High $144.54 | Professional | 52 · Reduced service | $46.77 | $53.70 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $41.69 Typical High $57.54 | Professional | 53 · Discontinued | $18.62 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $154.88 Typical High $218.78 | Professional | 54 · Surgery only | $70.79 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.85 Typical High $43.65 | Professional | 55 · Aftercare only | $14.13 | $15.85 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.72 Typical High $28.84 | Professional | 56 · Pre-op care only | $9.33 | $10.72 | $28.84 |
Where Maryland sits
The same service costs 3.6 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· 39th of 51
$240
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.