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 $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $69.18 | Professional | None | $51.29 | $57.54 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $316.23 Typical High $588.84 | Facility | None | $229.09 | $316.23 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $79.43 | Professional | None | $45.71 | $50.12 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $72.44 | Professional | None | $41.69 | $45.71 | $72.44 |
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 $41.69 Median $48.98 Typical High $93.33 | Professional | None | $41.69 | $48.98 | $93.33 |
Wellpoint Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | None | $43.65 | $43.65 | $57.54 |
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 $30.20 Median $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 54 · Surgery only | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.17 |
Where Maryland sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 40th of 51
$57.54
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.