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 $338.84 Median $1,230.27 Typical High $2,089.30 | Professional | None | $338.84 | $1,230.27 | $2,089.30 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | None | $275.42 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $6,309.57 | Facility | None | $512.86 | $3,548.13 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $912.01 Typical High $2,454.71 | Professional | None | $269.15 | $912.01 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,621.81 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $295.12 Median $1,230.27 Typical High $3,548.13 | Professional | None | $295.12 | $1,230.27 | $3,548.13 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,318.26 | $2,187.76 |
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 $177.83 Median $616.60 Typical High $912.01 | Professional | 52 · Reduced service | $177.83 | $616.60 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $251.19 Typical High $363.08 | Professional | 53 · Discontinued | $70.79 | $251.19 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $933.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $269.15 | $933.25 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $186.21 Typical High $275.42 | Professional | 55 · Aftercare only | $53.70 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $123.03 Typical High $181.97 | Professional | 56 · Pre-op care only | $35.48 | $123.03 | $181.97 |
Where Maryland sits
The same service costs 6.0 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· 36th of 51
$1,445
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.