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 $426.58 Median $426.58 Typical High $436.52 | Professional | None | $426.58 | $426.58 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $501.19 | Professional | None | $363.08 | $407.38 | $501.19 |
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 $363.08 Median $389.05 Typical High $602.56 | Professional | None | $363.08 | $389.05 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $562.34 | Professional | None | $331.13 | $363.08 | $562.34 |
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 $331.13 Median $371.54 Typical High $724.44 | Professional | None | $331.13 | $371.54 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $457.09 | Professional | None | $309.03 | $309.03 | $457.09 |
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 $208.93 Median $208.93 Typical High $218.78 | Professional | 52 · Reduced service | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $43.65 |
Where Maryland sits
The same service costs 4.6 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
$407
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.