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 $141.25 Median $436.52 Typical High $549.54 | Professional | None | $141.25 | $436.52 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $173.78 | Professional | None | $134.90 | $151.36 | $173.78 |
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 $138.04 Median $436.52 Typical High $1,047.13 | Professional | None | $138.04 | $436.52 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,096.48 | Professional | None | $501.19 | $602.56 | $1,096.48 |
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 $151.36 Median $446.68 Typical High $1,258.93 | Professional | None | $151.36 | $446.68 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $794.33 | Professional | None | $131.83 | $131.83 | $794.33 |
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 $70.79 Median $218.78 Typical High $275.42 | Professional | 52 · Reduced service | $70.79 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $28.84 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $323.59 Typical High $416.87 | Professional | 54 · Surgery only | $107.15 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $64.57 Typical High $83.18 | Professional | 55 · Aftercare only | $21.38 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $43.65 Typical High $54.95 | Professional | 56 · Pre-op care only | $14.13 | $43.65 | $54.95 |
Where Maryland sits
The same service costs 3.5 times more in Iowa than in Maryland. 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· 51st of 51
$240
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.