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 $169.82 Median $169.82 Typical High $173.78 | Professional | None | $169.82 | $169.82 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $199.53 | Professional | None | $144.54 | $162.18 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $1,698.24 | Facility | None | $512.86 | $912.01 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $251.19 | Professional | None | $144.54 | $154.88 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $218.78 | Professional | None | $134.90 | $147.91 | $218.78 |
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 $134.90 Median $158.49 Typical High $288.40 | Professional | None | $134.90 | $158.49 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $181.97 | Professional | None | $123.03 | $123.03 | $181.97 |
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 $85.11 Median $85.11 Typical High $87.10 | Professional | 52 · Reduced service | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 53 · Discontinued | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 54 · Surgery only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $17.38 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $17.38 |
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
$162
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.