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 $257.04 Median $269.15 Typical High $275.42 | Professional | None | $257.04 | $269.15 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | None | $281.84 | $316.23 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $691.83 | Professional | None | $269.15 | $338.84 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $489.78 | Professional | None | $263.03 | $295.12 | $489.78 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $707.95 | Professional | None | $257.04 | $371.54 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $389.05 | Professional | None | $263.03 | $263.03 | $389.05 |
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 $128.82 Median $134.90 Typical High $138.04 | Professional | 52 · Reduced service | $128.82 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $54.95 | Professional | 53 · Discontinued | $51.29 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $190.55 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $27.54 |
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· 46th of 51
$316
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.