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 $269.15 Median $269.15 Typical High $275.42 | Professional | None | $269.15 | $269.15 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $309.03 | Professional | None | $229.09 | $257.04 | $309.03 |
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 $229.09 Median $245.47 Typical High $371.54 | Professional | None | $229.09 | $245.47 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $354.81 | Professional | None | $213.80 | $234.42 | $354.81 |
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 $186.21 Median $229.09 Typical High $457.09 | Professional | None | $186.21 | $229.09 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $288.40 | Professional | None | $194.98 | $194.98 | $288.40 |
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 $134.90 Median $134.90 Typical High $138.04 | Professional | 52 · Reduced service | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | 53 · Discontinued | $53.70 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 54 · Surgery only | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $27.54 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $27.54 |
Where Maryland sits
The same service costs 4.1 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
$257
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.