How much rates vary
Facilitymedian $69 · 10th to 90th $14 to $617Professionalmedian $138 · 10th to 90th $107 to $229
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 (both parts) Typical Low $125.89 Median $128.82 Typical High $138.04 | Professional | None (both parts) | $125.89 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $114.82 Typical High $120.23 | Professional | 26 · Professional part | $112.20 | $114.82 | $120.23 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $13.49 Median $15.85 Typical High $18.20 | Professional | TC · Technical part | $13.49 | $15.85 | $18.20 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $123.03 Median $138.04 Typical High $169.82 | Professional | None (both parts) | $123.03 | $138.04 | $169.82 |
CareFirst Setting Professional Modifier 26 · Professional part Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 26 · Professional part | $107.15 | $120.23 | $120.23 |
CareFirst Setting Professional Modifier TC · Technical part Typical Low $15.85 Median $17.78 Typical High $17.78 | Professional | TC · Technical part | $15.85 | $17.78 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $20.42 Typical High $66.07 | Facility | None | $13.49 | $20.42 | $66.07 |
Cigna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $141.25 Typical High $371.54 | Professional | None (both parts) | $123.03 | $141.25 | $371.54 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $109.65 Median $128.82 Typical High $323.59 | Professional | 26 · Professional part | $109.65 | $128.82 | $323.59 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $13.18 Median $16.22 Typical High $47.86 | Professional | TC · Technical part | $13.18 | $16.22 | $47.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $245.47 | Professional | None | $128.82 | $151.36 | $245.47 |
Kaiser Permanente Setting Professional Modifier 26 · Professional part Typical Low $114.82 Median $131.83 Typical High $181.97 | Professional | 26 · Professional part | $114.82 | $131.83 | $181.97 |
Kaiser Permanente Setting Professional Modifier TC · Technical part Typical Low $16.60 Median $19.05 Typical High $25.70 | Professional | TC · Technical part | $16.60 | $19.05 | $25.70 |
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 (both parts) Typical Low $107.15 Median $162.18 Typical High $323.59 | Professional | None (both parts) | $107.15 | $162.18 | $323.59 |
United Setting Professional Modifier 26 · Professional part Typical Low $95.50 Median $147.91 Typical High $281.84 | Professional | 26 · Professional part | $95.50 | $147.91 | $281.84 |
United Setting Professional Modifier TC · Technical part Typical Low $11.22 Median $16.22 Typical High $33.11 | Professional | TC · Technical part | $11.22 | $16.22 | $33.11 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $95.50 Median $95.50 Typical High $199.53 | Professional | None (both parts) | $95.50 | $95.50 | $199.53 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $83.18 Median $83.18 Typical High $173.78 | Professional | 26 · Professional part | $83.18 | $83.18 | $173.78 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $11.75 Median $11.75 Typical High $25.12 | Professional | TC · Technical part | $11.75 | $11.75 | $25.12 |
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 $63.10 Median $64.57 Typical High $69.18 | Professional | 52 · Reduced service | $63.10 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 53 · Discontinued | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 54 · Surgery only | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $20.89 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $13.80 |
Where Maryland sits
The same service costs 4.7 times more in Alaska than in Alabama. 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· 42nd of 51
$132
AK $490AL $105
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.