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 $245.47 Median $616.60 Typical High $912.01 | Professional | None | $245.47 | $616.60 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $295.12 | Professional | None | $213.80 | $239.88 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,230.27 Typical High $2,290.87 | Facility | None | $588.84 | $1,230.27 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $512.86 Typical High $870.96 | Professional | None | $218.78 | $512.86 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,288.25 | Professional | None | $691.83 | $933.25 | $1,288.25 |
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 $199.53 Median $549.54 Typical High $1,023.29 | Professional | None | $199.53 | $549.54 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,096.48 | Professional | None | $602.56 | $602.56 | $1,096.48 |
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 $123.03 Median $302.00 Typical High $446.68 | Professional | 52 · Reduced service | $123.03 | $302.00 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $120.23 Typical High $181.97 | Professional | 53 · Discontinued | $48.98 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $446.68 Typical High $676.08 | Professional | 54 · Surgery only | $186.21 | $446.68 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $89.13 Typical High $134.90 | Professional | 55 · Aftercare only | $37.15 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $60.26 Typical High $91.20 | Professional | 56 · Pre-op care only | $24.55 | $60.26 | $91.20 |
Where Maryland sits
The same service costs 4.3 times more in Alaska than in Washington, DC. 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· 50th of 51
$331
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.