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 $416.87 Median $1,288.25 Typical High $1,698.24 | Professional | None | $416.87 | $1,288.25 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $407.38 | Professional | None | $323.59 | $354.81 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,981.07 | Facility | None | $512.86 | $2,238.72 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $891.25 Typical High $2,344.23 | Professional | None | $316.23 | $891.25 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,479.11 | $2,754.23 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $6,025.60 | Facility | None | $954.99 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,202.26 Typical High $3,311.31 | Professional | None | $363.08 | $1,202.26 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,288.25 | $1,995.26 |
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 $208.93 Median $645.65 Typical High $851.14 | Professional | 52 · Reduced service | $208.93 | $645.65 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $257.04 Typical High $346.74 | Professional | 53 · Discontinued | $83.18 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $954.99 Typical High $1,288.25 | Professional | 54 · Surgery only | $309.03 | $954.99 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $190.55 Typical High $257.04 | Professional | 55 · Aftercare only | $63.10 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $128.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $41.69 | $128.82 | $169.82 |
Where Maryland sits
The same service costs 5.1 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
$1,288
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.