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 $114.82 Median $114.82 Typical High $117.49 | Professional | None | $114.82 | $114.82 | $117.49 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $128.82 | Professional | None | $114.82 | $125.89 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $416.87 Typical High $741.31 | Facility | None | $331.13 | $416.87 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $295.12 | Professional | None | $104.71 | $128.82 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $204.17 | Professional | None | $120.23 | $134.90 | $204.17 |
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 $97.72 Median $147.91 Typical High $288.40 | Professional | None | $97.72 | $147.91 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $177.83 | Professional | None | $102.33 | $102.33 | $177.83 |
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 $57.54 Median $57.54 Typical High $58.88 | Professional | 52 · Reduced service | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 53 · Discontinued | $22.91 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $87.10 Typical High $89.13 | Professional | 54 · Surgery only | $85.11 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $17.78 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.75 |
Where Maryland sits
The same service costs 4.4 times more in Alaska than in New York. 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· 39th of 51
$151
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.