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 $120.23 Median $144.54 Typical High $295.12 | Professional | None | $120.23 | $144.54 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $173.78 | Professional | None | $134.90 | $147.91 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $67.61 Typical High $114.82 | Facility | None | $50.12 | $67.61 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $346.74 | Professional | None | $125.89 | $173.78 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $275.42 | Professional | None | $169.82 | $194.98 | $275.42 |
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 $125.89 Median $194.98 Typical High $346.74 | Professional | None | $125.89 | $194.98 | $346.74 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
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 $60.26 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $104.71 Typical High $117.49 | Professional | 54 · Surgery only | $89.13 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.89 Typical High $23.44 | Professional | 55 · Aftercare only | $17.78 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $15.85 |
Where Maryland sits
The same service costs 2.9 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· 47th of 51
$158
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.