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 $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $407.38 | Professional | None | $295.12 | $323.59 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,168.69 Typical High $6,918.31 | Facility | None | $512.86 | $4,168.69 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $537.03 | Professional | None | $309.03 | $331.13 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $478.63 | Professional | None | $295.12 | $323.59 | $478.63 |
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 $288.40 Median $346.74 Typical High $645.65 | Professional | None | $288.40 | $346.74 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $407.38 | Professional | None | $288.40 | $288.40 | $407.38 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | 53 · Discontinued | $72.44 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $275.42 | Professional | 54 · Surgery only | $269.15 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Where Maryland sits
The same service costs 4.5 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· 47th of 51
$324
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.