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 $275.42 Median $281.84 Typical High $281.84 | Professional | None | $275.42 | $281.84 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $331.13 | Professional | None | $245.47 | $269.15 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $1,202.26 | Facility | None | $512.86 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $398.11 | Professional | None | $234.42 | $251.19 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $354.81 | Professional | None | $218.78 | $239.88 | $354.81 |
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 $208.93 Median $251.19 Typical High $467.74 | Professional | None | $208.93 | $251.19 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $295.12 | Professional | None | $204.17 | $204.17 | $295.12 |
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 $138.04 Median $138.04 Typical High $141.25 | Professional | 52 · Reduced service | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | 53 · Discontinued | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | 54 · Surgery only | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $28.18 |
Where Maryland sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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· 40th of 51
$269
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.