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 $173.78 Median $177.83 Typical High $181.97 | Professional | None | $173.78 | $177.83 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $208.93 | Professional | None | $151.36 | $169.82 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $912.01 Typical High $1,621.81 | Facility | None | $446.68 | $912.01 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $275.42 | Professional | None | $151.36 | $162.18 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $234.42 | Professional | None | $141.25 | $154.88 | $234.42 |
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 $138.04 Median $158.49 Typical High $302.00 | Professional | None | $138.04 | $158.49 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $190.55 | Professional | None | $128.82 | $128.82 | $190.55 |
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 $87.10 Median $87.10 Typical High $89.13 | Professional | 52 · Reduced service | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 54 · Surgery only | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $26.92 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.78 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.78 |
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· 41st of 51
$170
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.