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 $24.55 Median $32.36 Typical High $66.07 | Professional | None | $24.55 | $32.36 | $66.07 |
CareFirst Setting Professional Modifier None Typical Low $28.84 Median $32.36 Typical High $35.48 | Professional | None | $28.84 | $32.36 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $398.11 Typical High $2,691.53 | Facility | None | $316.23 | $398.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $85.11 | Professional | None | $26.30 | $38.90 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $47.86 Typical High $77.62 | Professional | None | $41.69 | $47.86 | $77.62 |
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 $27.54 Median $45.71 Typical High $79.43 | Professional | None | $27.54 | $45.71 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $63.10 | Professional | None | $38.02 | $38.02 | $63.10 |
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 $12.02 Median $16.22 Typical High $16.60 | Professional | 52 · Reduced service | $12.02 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $4.90 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $24.55 Typical High $24.55 | Professional | 54 · Surgery only | $18.20 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $3.63 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.24 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.45 | $3.24 | $3.31 |
Where Maryland sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 45th of 51
$39.81
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.