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 $102.33 Median $213.80 Typical High $275.42 | Professional | None | $102.33 | $213.80 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $114.82 | Professional | None | $77.62 | $87.10 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,621.81 Typical High $2,884.03 | Facility | None | $331.13 | $1,621.81 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $177.83 Typical High $346.74 | Professional | None | $83.18 | $177.83 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $389.05 | Professional | None | $194.98 | $263.03 | $389.05 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $95.50 Median $204.17 Typical High $457.09 | Professional | None | $95.50 | $204.17 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $354.81 | Professional | None | $190.55 | $190.55 | $354.81 |
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 $50.12 Median $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $50.12 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $20.42 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $141.25 Typical High $186.21 | Professional | 54 · Surgery only | $75.86 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $15.14 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $19.05 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.23 | $19.05 | $24.55 |
Where Maryland sits
The same service costs 4.1 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· 42nd of 51
$234
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.