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 $213.80 Median $213.80 Typical High $223.87 | Professional | None | $213.80 | $213.80 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $257.04 | Professional | None | $186.21 | $208.93 | $257.04 |
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 $186.21 Median $199.53 Typical High $316.23 | Professional | None | $186.21 | $199.53 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $275.42 | Professional | None | $169.82 | $181.97 | $275.42 |
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 $162.18 Median $190.55 Typical High $354.81 | Professional | None | $162.18 | $190.55 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $229.09 | Professional | None | $162.18 | $162.18 | $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 $107.15 Median $107.15 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $44.67 | Professional | 53 · Discontinued | $43.65 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 54 · Surgery only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $22.39 |
Where Maryland sits
The same service costs 4.8 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· 40th of 51
$209
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.