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 $199.53 Median $223.87 Typical High $416.87 | Professional | None | $199.53 | $223.87 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $2,691.53 | Facility | None | $501.19 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $457.09 | Professional | None | $173.78 | $181.97 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $346.74 | Professional | None | $165.96 | $190.55 | $346.74 |
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 $162.18 Median $229.09 Typical High $489.78 | Professional | None | $162.18 | $229.09 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $251.19 | Professional | None | $147.91 | $147.91 | $251.19 |
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 $102.33 Median $109.65 Typical High $112.20 | Professional | 52 · Reduced service | $102.33 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $43.65 Typical High $44.67 | Professional | 53 · Discontinued | $40.74 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $22.39 |
Where Maryland sits
The same service costs 4.4 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· 49th of 51
$200
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.