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 $125.89 Median $128.82 Typical High $128.82 | Professional | None | $125.89 | $128.82 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | None | $123.03 | $138.04 | $138.04 |
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 $117.49 Median $154.88 Typical High $331.13 | Professional | None | $117.49 | $154.88 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $223.87 | Professional | None | $123.03 | $138.04 | $223.87 |
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 $114.82 Median $169.82 Typical High $316.23 | Professional | None | $114.82 | $169.82 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $181.97 | Professional | None | $120.23 | $120.23 | $181.97 |
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 $63.10 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $25.12 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.05 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $12.88 |
Where Maryland sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 48th of 51
$141
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.