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 $147.91 Median $147.91 Typical High $154.88 | Professional | None | $147.91 | $147.91 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $181.97 | Professional | None | $128.82 | $144.54 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $912.01 Typical High $1,621.81 | Facility | None | $331.13 | $912.01 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $263.03 | Professional | None | $128.82 | $138.04 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $223.87 | Professional | None | $120.23 | $131.83 | $223.87 |
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 $120.23 Median $177.83 Typical High $288.40 | Professional | None | $120.23 | $177.83 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $162.18 | Professional | None | $125.89 | $125.89 | $162.18 |
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 $74.13 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 54 · Surgery only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $15.49 |
Where Maryland sits
The same service costs 5.4 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· 45th of 51
$145
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.