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 $147.91 Median $162.18 Typical High $204.17 | Professional | None | $147.91 | $162.18 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | None | $144.54 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $134.90 Typical High $588.84 | Facility | None | $85.11 | $134.90 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $426.58 | Professional | None | $144.54 | $190.55 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $309.03 | Professional | None | $194.98 | $229.09 | $309.03 |
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 $131.83 Median $208.93 Typical High $426.58 | Professional | None | $131.83 | $208.93 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $302.00 | Professional | None | $194.98 | $281.84 | $302.00 |
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 $74.13 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $29.51 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $109.65 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $16.22 | $20.42 |
Where Maryland sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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
$186
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.