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 $208.93 Median $208.93 Typical High $213.80 | Professional | None | $208.93 | $208.93 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $245.47 | Professional | None | $181.97 | $199.53 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,265.80 Typical High $6,918.31 | Facility | None | $588.84 | $4,265.80 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $309.03 | Professional | None | $177.83 | $194.98 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $275.42 | Professional | None | $169.82 | $186.21 | $275.42 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $354.81 | Professional | None | $158.49 | $186.21 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $229.09 | Professional | None | $158.49 | $158.49 | $229.09 |
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 $104.71 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 53 · Discontinued | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 54 · Surgery only | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $21.38 |
Where Maryland sits
The same service costs 4.7 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· 42nd of 51
$200
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.