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 $102.33 Median $109.65 Typical High $109.65 | Professional | None | $102.33 | $109.65 | $109.65 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | None | $114.82 | $125.89 | $147.91 |
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 $104.71 Median $123.03 Typical High $257.04 | Professional | None | $104.71 | $123.03 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $204.17 | Professional | None | $104.71 | $117.49 | $204.17 |
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 $102.33 Median $151.36 Typical High $288.40 | Professional | None | $102.33 | $151.36 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $154.88 | Professional | None | $104.71 | $104.71 | $154.88 |
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 $51.29 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $20.42 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $81.28 Typical High $83.18 | Professional | 54 · Surgery only | $77.62 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $16.60 | Professional | 55 · Aftercare only | $15.49 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $10.96 |
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· 44th of 51
$126
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.