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 $46.77 Median $93.33 Typical High $147.91 | Professional | None | $46.77 | $93.33 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $57.54 | Professional | None | $41.69 | $46.77 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $588.84 | Facility | None | $50.12 | $52.48 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $95.50 Typical High $131.83 | Professional | None | $39.81 | $95.50 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $208.93 | Professional | None | $102.33 | $147.91 | $208.93 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $33.11 Median $70.79 Typical High $134.90 | Professional | None | $33.11 | $70.79 | $134.90 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $173.78 | Professional | None | $70.79 | $70.79 | $173.78 |
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 $23.44 Median $35.48 Typical High $74.13 | Professional | 52 · Reduced service | $23.44 | $35.48 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $14.13 Typical High $29.51 | Professional | 53 · Discontinued | $9.33 | $14.13 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $53.70 Typical High $112.20 | Professional | 54 · Surgery only | $34.67 | $53.70 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.72 Typical High $22.39 | Professional | 55 · Aftercare only | $7.08 | $10.72 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.08 Typical High $14.79 | Professional | 56 · Pre-op care only | $4.68 | $7.08 | $14.79 |
Where Maryland sits
The same service costs 3.4 times more in Alaska than in Washington, DC. 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· 50th of 51
$57.54
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.