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 $354.81 Median $3,467.37 Typical High $4,786.30 | Professional | None | $354.81 | $3,467.37 | $4,786.30 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $338.84 | Professional | None | $288.40 | $316.23 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,585.78 Typical High $13,182.57 | Facility | None | $512.86 | $7,585.78 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $933.25 Typical High $6,309.57 | Professional | None | $281.84 | $933.25 | $6,309.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,090.30 Median $4,073.80 Typical High $7,585.78 | Professional | None | $3,090.30 | $4,073.80 | $7,585.78 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,413.10 Typical High $16,218.10 | Facility | None | $3,019.95 | $7,413.10 | $16,218.10 |
United Setting Professional Modifier None Typical Low $316.23 Median $2,818.38 Typical High $7,943.28 | Professional | None | $316.23 | $2,818.38 | $7,943.28 |
Wellpoint Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $5,495.41 | Professional | None | $3,388.44 | $3,388.44 | $5,495.41 |
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 $186.21 Median $1,737.80 Typical High $2,344.23 | Professional | 52 · Reduced service | $186.21 | $1,737.80 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $691.83 Typical High $933.25 | Professional | 53 · Discontinued | $74.13 | $691.83 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $2,570.40 Typical High $3,548.13 | Professional | 54 · Surgery only | $275.42 | $2,570.40 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $512.86 Typical High $707.95 | Professional | 55 · Aftercare only | $54.95 | $512.86 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $346.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $37.15 | $346.74 | $467.74 |
Where Maryland sits
The same service costs 15.5 times more in Alaska 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· 30th of 51
$3,548
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.