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 $263.03 Median $436.52 Typical High $524.81 | Professional | None | $263.03 | $436.52 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $309.03 | Professional | None | $229.09 | $251.19 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $1,202.26 | Facility | None | $446.68 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $588.84 | Professional | None | $234.42 | $407.38 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $758.58 | Professional | None | $380.19 | $549.54 | $758.58 |
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 $213.80 Median $389.05 Typical High $660.69 | Professional | None | $213.80 | $389.05 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $645.65 | Professional | None | $380.19 | $380.19 | $645.65 |
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 $131.83 Median $186.21 Typical High $263.03 | Professional | 52 · Reduced service | $131.83 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $74.13 Typical High $104.71 | Professional | 53 · Discontinued | $52.48 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $194.98 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $56.23 Typical High $79.43 | Professional | 55 · Aftercare only | $39.81 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $52.48 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $52.48 |
Where Maryland sits
The same service costs 3.4 times more in Alaska than in Virginia. 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
$339
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.