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 $331.13 Median $363.08 Typical High $426.58 | Professional | None | $331.13 | $363.08 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $371.54 | Professional | None | $302.00 | $331.13 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $2,691.53 Typical High $4,466.84 | Facility | None | $331.13 | $2,691.53 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $1,000.00 | Professional | None | $323.59 | $416.87 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $794.33 | Professional | None | $426.58 | $501.19 | $794.33 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $831.76 | Professional | None | $302.00 | $478.63 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $660.69 | Professional | None | $309.03 | $309.03 | $660.69 |
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 $165.96 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $251.19 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $42.66 |
Where Maryland sits
The same service costs 4.1 times more in Alaska than in New York. 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· 43rd of 51
$427
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.