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 $42.66 Median $42.66 Typical High $43.65 | Professional | None | $42.66 | $42.66 | $43.65 |
CareFirst Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $52.48 | Professional | None | $38.90 | $43.65 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $2,691.53 | Facility | None | $501.19 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $67.61 | Professional | None | $37.15 | $39.81 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $54.95 | Professional | None | $35.48 | $38.02 | $54.95 |
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 $34.67 Median $40.74 Typical High $75.86 | Professional | None | $34.67 | $40.74 | $75.86 |
Wellpoint Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | None | $36.31 | $36.31 | $47.86 |
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 $21.38 Median $21.38 Typical High $21.88 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 54 · Surgery only | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.37 |
Where Maryland sits
The same service costs 4.3 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· 45th of 51
$42.66
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.