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 $77.62 Median $117.49 Typical High $147.91 | Professional | None | $77.62 | $117.49 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | None | $67.61 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $134.90 | Facility | None | $50.12 | $79.43 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $165.96 | Professional | None | $69.18 | $109.65 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $263.03 | Professional | None | $114.82 | $144.54 | $263.03 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $208.93 | Professional | None | $63.10 | $109.65 | $208.93 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $199.53 | Professional | None | $102.33 | $102.33 | $199.53 |
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 $38.02 Median $42.66 Typical High $74.13 | Professional | 52 · Reduced service | $38.02 | $42.66 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.98 Typical High $29.51 | Professional | 53 · Discontinued | $15.49 | $16.98 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $63.10 Typical High $109.65 | Professional | 54 · Surgery only | $57.54 | $63.10 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.59 Typical High $22.39 | Professional | 55 · Aftercare only | $11.48 | $12.59 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.51 Typical High $14.79 | Professional | 56 · Pre-op care only | $7.76 | $8.51 | $14.79 |
Where Maryland sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 51st of 51
$95.50
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.