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 $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $144.54 | Professional | None | $107.15 | $120.23 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $173.78 | Professional | None | $107.15 | $114.82 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $162.18 | Professional | None | $100.00 | $109.65 | $162.18 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $213.80 | Professional | None | $87.10 | $107.15 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $134.90 | Professional | None | $91.20 | $91.20 | $134.90 |
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 $63.10 Median $63.10 Typical High $64.57 | Professional | 52 · Reduced service | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 54 · Surgery only | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $12.88 |
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· 38th of 51
$120
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.