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 $251.19 Median $269.15 Typical High $302.00 | Professional | None | $251.19 | $269.15 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $331.13 | Professional | None | $257.04 | $281.84 | $331.13 |
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 $251.19 Median $316.23 Typical High $691.83 | Professional | None | $251.19 | $316.23 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $467.74 | Professional | None | $257.04 | $288.40 | $467.74 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $676.08 | Professional | None | $239.88 | $354.81 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $380.19 | Professional | None | $213.80 | $213.80 | $380.19 |
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 $125.89 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $125.89 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $53.70 | Professional | 53 · Discontinued | $50.12 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $26.92 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $26.92 |
Where Maryland sits
The same service costs 4.4 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· 47th of 51
$295
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.