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 $234.42 Median $524.81 Typical High $758.58 | Professional | None | $234.42 | $524.81 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $281.84 | Professional | None | $204.17 | $223.87 | $281.84 |
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 $208.93 Median $457.09 Typical High $776.25 | Professional | None | $208.93 | $457.09 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,071.52 | Professional | None | $537.03 | $776.25 | $1,071.52 |
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 $199.53 Median $524.81 Typical High $912.01 | Professional | None | $199.53 | $524.81 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $912.01 | Professional | None | $512.86 | $512.86 | $912.01 |
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 $117.49 Median $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $117.49 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $102.33 Typical High $151.36 | Professional | 53 · Discontinued | $46.77 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $380.19 Typical High $562.34 | Professional | 54 · Surgery only | $173.78 | $380.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $77.62 Typical High $112.20 | Professional | 55 · Aftercare only | $34.67 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $51.29 Typical High $75.86 | Professional | 56 · Pre-op care only | $23.44 | $51.29 | $75.86 |
Where Maryland sits
The same service costs 4.1 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· 47th of 51
$316
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.