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 $102.33 Median $158.49 Typical High $275.42 | Professional | None | $102.33 | $158.49 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $144.54 | Professional | None | $95.50 | $107.15 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,023.29 Typical High $1,659.59 | Facility | None | $331.13 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $309.03 | Professional | None | $97.72 | $154.88 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $316.23 | Professional | None | $162.18 | $186.21 | $316.23 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,380.38 Typical High $2,570.40 | Facility | None | $776.25 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $354.81 | Professional | None | $91.20 | $173.78 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $245.47 | Professional | None | $144.54 | $144.54 | $245.47 |
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 $51.29 Median $66.07 Typical High $87.10 | Professional | 52 · Reduced service | $51.29 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $20.42 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $100.00 Typical High $131.83 | Professional | 54 · Surgery only | $75.86 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $15.14 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $17.78 |
Where Maryland sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 37th of 51
$178
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.