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 $138.04 Median $158.49 Typical High $309.03 | Professional | None | $138.04 | $158.49 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $125.89 | Professional | None | $104.71 | $117.49 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $1,174.90 | Facility | None | $446.68 | $676.08 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $223.87 Typical High $416.87 | Professional | None | $109.65 | $223.87 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $524.81 | Professional | None | $234.42 | $316.23 | $524.81 |
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 $104.71 Median $229.09 Typical High $537.03 | Professional | None | $104.71 | $229.09 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $426.58 | Professional | None | $165.96 | $165.96 | $426.58 |
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 $69.18 Median $79.43 Typical High $154.88 | Professional | 52 · Reduced service | $69.18 | $79.43 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $31.62 Typical High $61.66 | Professional | 53 · Discontinued | $27.54 | $31.62 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $120.23 Typical High $229.09 | Professional | 54 · Surgery only | $102.33 | $120.23 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $23.99 Typical High $45.71 | Professional | 55 · Aftercare only | $20.42 | $23.99 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.85 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.80 | $15.85 | $30.90 |
Where Maryland sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 29th of 51
$282
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.