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 $128.82 Median $128.82 Typical High $131.83 | Professional | None | $128.82 | $128.82 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $131.83 | Professional | None | $97.72 | $109.65 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $676.08 | Facility | None | $229.09 | $363.08 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $165.96 | Professional | None | $97.72 | $107.15 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $144.54 | Professional | None | $87.10 | $95.50 | $144.54 |
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 $79.43 Median $102.33 Typical High $194.98 | Professional | None | $79.43 | $102.33 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $120.23 | Professional | None | $77.62 | $77.62 | $120.23 |
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 $64.57 Median $64.57 Typical High $66.07 | Professional | 52 · Reduced service | $64.57 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | 53 · Discontinued | $25.70 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 54 · Surgery only | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $13.18 |
Where Maryland sits
The same service costs 4.8 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· 41st of 51
$110
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.