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 $120.23 Median $120.23 Typical High $123.03 | Professional | None | $120.23 | $120.23 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $144.54 | Professional | None | $107.15 | $120.23 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $165.96 | Professional | None | $100.00 | $109.65 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $154.88 | Professional | None | $95.50 | $102.33 | $154.88 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $204.17 | Professional | None | $83.18 | $102.33 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $128.82 | Professional | None | $85.11 | $85.11 | $128.82 |
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 $60.26 Median $60.26 Typical High $61.66 | Professional | 52 · Reduced service | $60.26 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 53 · Discontinued | $23.99 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.30 |
Where Maryland sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 39th of 51
$117
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.