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 $190.55 Median $204.17 Typical High $204.17 | Professional | None | $190.55 | $204.17 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $251.19 | Professional | None | $186.21 | $208.93 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $1,548.82 | Facility | None | $512.86 | $891.25 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $524.81 | Professional | None | $194.98 | $251.19 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $380.19 | Professional | None | $186.21 | $208.93 | $380.19 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $512.86 | Professional | None | $190.55 | $316.23 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $275.42 | Professional | None | $186.21 | $186.21 | $275.42 |
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 $95.50 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $20.42 |
Where Maryland sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 40th of 51
$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.