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 $60.26 Median $72.44 Typical High $109.65 | Professional | None | $60.26 | $72.44 | $109.65 |
CareFirst Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $66.07 | Professional | None | $54.95 | $60.26 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $436.52 | Facility | None | $128.82 | $213.80 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $177.83 | Professional | None | $58.88 | $75.86 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $125.89 | Professional | None | $75.86 | $87.10 | $125.89 |
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 $54.95 Median $87.10 Typical High $169.82 | Professional | None | $54.95 | $87.10 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | None | $57.54 | $57.54 | $114.82 |
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 $30.20 Median $33.11 Typical High $39.81 | Professional | 52 · Reduced service | $30.20 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $15.85 | Professional | 53 · Discontinued | $12.02 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $48.98 Typical High $58.88 | Professional | 54 · Surgery only | $44.67 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $8.91 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.61 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.03 | $6.61 | $7.94 |
Where Maryland sits
The same service costs 3.7 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· 40th of 51
$79.43
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.