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 $131.83 Median $131.83 Typical High $134.90 | Professional | None | $131.83 | $131.83 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $147.91 | Professional | None | $109.65 | $120.23 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $4,265.80 Typical High $7,244.36 | Facility | None | $331.13 | $4,265.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $194.98 | Professional | None | $112.20 | $123.03 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $177.83 | Professional | None | $109.65 | $120.23 | $177.83 |
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 $93.33 Median $112.20 Typical High $223.87 | Professional | None | $93.33 | $112.20 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $147.91 | Professional | None | $91.20 | $91.20 | $147.91 |
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 $66.07 Median $66.07 Typical High $67.61 | Professional | 52 · Reduced service | $66.07 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.92 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | 54 · Surgery only | $100.00 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.49 |
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· 42nd of 51
$120
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.