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 $123.03 Median $125.89 Typical High $151.36 | Professional | None | $123.03 | $125.89 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $134.90 | Professional | None | $114.82 | $128.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $524.81 Typical High $912.01 | Facility | None | $331.13 | $524.81 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $380.19 | Professional | None | $138.04 | $173.78 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $263.03 | Professional | None | $141.25 | $162.18 | $263.03 |
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 $120.23 Median $177.83 Typical High $363.08 | Professional | None | $120.23 | $177.83 | $363.08 |
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 $61.66 Median $63.10 Typical High $70.79 | Professional | 52 · Reduced service | $61.66 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $28.18 | Professional | 53 · Discontinued | $24.55 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $14.13 |
Where Maryland sits
The same service costs 4.3 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· 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.