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 $107.15 Median $109.65 Typical High $112.20 | Professional | None | $107.15 | $109.65 | $112.20 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $123.03 | Professional | None | $107.15 | $120.23 | $123.03 |
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 $97.72 Median $123.03 Typical High $281.84 | Professional | None | $97.72 | $123.03 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $194.98 | Professional | None | $114.82 | $128.82 | $194.98 |
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 $144.54 Typical High $269.15 | Professional | None | $97.72 | $144.54 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $169.82 | Professional | None | $91.20 | $91.20 | $169.82 |
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 $53.70 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $53.70 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $22.39 | Professional | 53 · Discontinued | $21.38 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 54 · Surgery only | $81.28 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $11.22 |
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· 37th of 51
$145
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.