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 $165.96 Median $588.84 Typical High $794.33 | Professional | None | $165.96 | $588.84 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | None | $144.54 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $371.54 Typical High $1,071.52 | Professional | None | $141.25 | $371.54 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,348.96 | Professional | None | $537.03 | $707.95 | $1,348.96 |
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 $134.90 Median $562.34 Typical High $1,621.81 | Professional | None | $134.90 | $562.34 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $977.24 | Professional | None | $588.84 | $588.84 | $977.24 |
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 $87.10 Median $295.12 Typical High $398.11 | Professional | 52 · Reduced service | $87.10 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $117.49 Typical High $158.49 | Professional | 53 · Discontinued | $35.48 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $446.68 Typical High $588.84 | Professional | 54 · Surgery only | $131.83 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $89.13 Typical High $120.23 | Professional | 55 · Aftercare only | $26.30 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $58.88 Typical High $79.43 | Professional | 56 · Pre-op care only | $17.38 | $58.88 | $79.43 |
Where Maryland sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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· 47th of 51
$316
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.