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 $199.53 Median $199.53 Typical High $204.17 | Professional | None | $199.53 | $199.53 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $229.09 | Professional | None | $165.96 | $181.97 | $229.09 |
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 $169.82 Median $186.21 Typical High $302.00 | Professional | None | $169.82 | $186.21 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $269.15 | Professional | None | $158.49 | $177.83 | $269.15 |
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 $158.49 Median $177.83 Typical High $338.84 | Professional | None | $158.49 | $177.83 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $218.78 | Professional | None | $147.91 | $147.91 | $218.78 |
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 $100.00 Median $100.00 Typical High $102.33 | Professional | 52 · Reduced service | $100.00 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | 53 · Discontinued | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 54 · Surgery only | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $20.42 |
Where Maryland sits
The same service costs 5.5 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· 46th of 51
$182
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.