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 $173.78 Median $218.78 Typical High $223.87 | Professional | None | $173.78 | $218.78 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $251.19 | Professional | None | $204.17 | $229.09 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $602.56 | Facility | None | $154.88 | $251.19 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $588.84 | Professional | None | $194.98 | $269.15 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $457.09 | Professional | None | $269.15 | $309.03 | $457.09 |
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 $199.53 Median $316.23 Typical High $575.44 | Professional | None | $199.53 | $316.23 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $407.38 | Professional | None | $269.15 | $380.19 | $407.38 |
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 $87.10 Median $109.65 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $43.65 Typical High $44.67 | Professional | 53 · Discontinued | $35.48 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $162.18 Typical High $165.96 | Professional | 54 · Surgery only | $131.83 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $26.30 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.88 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $21.88 | $22.39 |
Where Maryland sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 51st of 51
$229
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.