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 $169.82 Median $177.83 Typical High $177.83 | Professional | None | $169.82 | $177.83 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $162.18 | Professional | None | $141.25 | $158.49 | $162.18 |
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 $131.83 Median $162.18 Typical High $363.08 | Professional | None | $131.83 | $162.18 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $281.84 | Professional | None | $134.90 | $154.88 | $281.84 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $398.11 | Professional | None | $134.90 | $194.98 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | None | $120.23 | $120.23 | $204.17 |
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 $85.11 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $85.11 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $33.88 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $25.12 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $17.78 |
Where Maryland sits
The same service costs 4.9 times more in Colorado 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· 46th of 51
$191
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.