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 $114.82 Median $446.68 Typical High $1,862.09 | Professional | None | $114.82 | $446.68 | $1,862.09 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | None | $87.10 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,398.83 Typical High $3,890.45 | Facility | None | $512.86 | $2,398.83 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $302.00 Typical High $2,454.71 | Professional | None | $95.50 | $302.00 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,698.24 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $91.20 Median $1,096.48 Typical High $3,981.07 | Professional | None | $91.20 | $1,096.48 | $3,981.07 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,148.15 | $2,290.87 |
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 $57.54 Median $512.86 Typical High $933.25 | Professional | 52 · Reduced service | $57.54 | $512.86 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $204.17 Typical High $371.54 | Professional | 53 · Discontinued | $22.91 | $204.17 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $776.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $87.10 | $776.25 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $154.88 Typical High $275.42 | Professional | 55 · Aftercare only | $17.38 | $154.88 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $102.33 Typical High $186.21 | Professional | 56 · Pre-op care only | $11.48 | $102.33 | $186.21 |
Where Maryland sits
The same service costs 19.1 times more in Alaska than in Nebraska. 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
$1,175
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.