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 $389.05 Median $389.05 Typical High $398.11 | Professional | None | $389.05 | $389.05 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $467.74 | Professional | None | $354.81 | $389.05 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $2,137.96 Typical High $3,548.13 | Facility | None | $331.13 | $2,137.96 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $1,096.48 | Professional | None | $363.08 | $426.58 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $630.96 | Professional | None | $338.84 | $389.05 | $630.96 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $912.01 | Professional | None | $331.13 | $489.78 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $512.86 | Professional | None | $295.12 | $295.12 | $512.86 |
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 $194.98 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $77.62 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $295.12 | Professional | 54 · Surgery only | $288.40 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $39.81 |
Where Maryland sits
The same service costs 4.0 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· 49th of 51
$398
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.