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 $446.68 Median $446.68 Typical High $467.74 | Professional | None | $446.68 | $446.68 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $537.03 | Professional | None | $389.05 | $426.58 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,570.88 Typical High $7,585.78 | Facility | None | $1,348.96 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $645.65 | Professional | None | $380.19 | $416.87 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $588.84 | Professional | None | $354.81 | $389.05 | $588.84 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $758.58 | Professional | None | $346.74 | $398.11 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
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 $223.87 Median $223.87 Typical High $229.09 | Professional | 52 · Reduced service | $223.87 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 54 · Surgery only | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $46.77 |
Where Maryland sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 39th of 51
$427
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.