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 $398.11 Median $457.09 Typical High $457.09 | Professional | None | $398.11 | $457.09 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $954.99 | Professional | None | $338.84 | $416.87 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $724.44 | Professional | None | $346.74 | $407.38 | $724.44 |
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 $338.84 Median $489.78 Typical High $1,000.00 | Professional | None | $338.84 | $489.78 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $524.81 | Professional | None | $331.13 | $331.13 | $524.81 |
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 $208.93 Median $223.87 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $45.71 |
Where Maryland sits
The same service costs 3.9 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· 49th of 51
$407
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.