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 $524.81 Median $524.81 Typical High $549.54 | Professional | None | $524.81 | $524.81 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $616.60 | Professional | None | $457.09 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,801.89 Typical High $6,760.83 | Facility | None | $588.84 | $3,801.89 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $758.58 | Professional | None | $446.68 | $489.78 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $691.83 | Professional | None | $416.87 | $457.09 | $691.83 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $891.25 | Professional | None | $398.11 | $489.78 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
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 $263.03 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $54.95 |
Where Maryland sits
The same service costs 4.5 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
$501
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.