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 $190.55 Typical High $194.98 | Professional | None | $190.55 | $190.55 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $229.09 | Professional | None | $165.96 | $186.21 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $1,698.24 | Facility | None | $588.84 | $933.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $288.40 | Professional | None | $162.18 | $177.83 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $245.47 | Professional | None | $147.91 | $162.18 | $245.47 |
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 $141.25 Median $173.78 Typical High $316.23 | Professional | None | $141.25 | $173.78 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | None | $147.91 | $147.91 | $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 $95.50 Median $95.50 Typical High $97.72 | Professional | 52 · Reduced service | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | 54 · Surgery only | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.50 |
Where Maryland sits
The same service costs 5.2 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· 39th of 51
$186
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.