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 $281.84 Median $354.81 Typical High $398.11 | Professional | None | $281.84 | $354.81 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $346.74 | Professional | None | $302.00 | $331.13 | $346.74 |
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 $295.12 Median $407.38 Typical High $851.14 | Professional | None | $295.12 | $407.38 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $724.44 | Professional | None | $426.58 | $501.19 | $724.44 |
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 $295.12 Median $478.63 Typical High $851.14 | Professional | None | $295.12 | $478.63 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $660.69 | Professional | None | $380.19 | $380.19 | $660.69 |
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 $141.25 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $141.25 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $263.03 Typical High $302.00 | Professional | 54 · Surgery only | $213.80 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $39.81 |
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· 50th of 51
$363
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.