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 $162.18 Median $173.78 Typical High $186.21 | Professional | None | $162.18 | $173.78 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $234.42 | Professional | None | $173.78 | $190.55 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $177.83 Typical High $288.40 | Facility | None | $154.88 | $177.83 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $457.09 | Professional | None | $169.82 | $213.80 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $309.03 | Professional | None | $169.82 | $190.55 | $309.03 |
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 $162.18 Median $239.88 Typical High $457.09 | Professional | None | $162.18 | $239.88 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $251.19 | Professional | None | $169.82 | $169.82 | $251.19 |
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 $81.28 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $32.36 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $128.82 Typical High $131.83 | Professional | 54 · Surgery only | $123.03 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $26.30 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $17.38 |
Where Maryland sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 48th 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.