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 $186.21 Median $199.53 Typical High $199.53 | Professional | None | $186.21 | $199.53 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $263.03 | Professional | None | $194.98 | $213.80 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $173.78 Typical High $302.00 | Facility | None | $50.12 | $173.78 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $524.81 | Professional | None | $194.98 | $239.88 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $354.81 | Professional | None | $190.55 | $213.80 | $354.81 |
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 $186.21 Median $275.42 Typical High $512.86 | Professional | None | $186.21 | $275.42 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $281.84 | Professional | None | $190.55 | $190.55 | $281.84 |
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 $91.20 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.90 Typical High $39.81 | Professional | 53 · Discontinued | $37.15 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $27.54 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.50 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.62 | $19.50 | $19.95 |
Where Maryland sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 49th of 51
$200
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.