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 $251.19 Median $251.19 Typical High $257.04 | Professional | None | $251.19 | $251.19 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | None | $234.42 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $758.58 Typical High $1,348.96 | Facility | None | $331.13 | $758.58 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $467.74 | Professional | None | $229.09 | $239.88 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $446.68 | Professional | None | $229.09 | $263.03 | $446.68 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $676.08 | Professional | None | $213.80 | $309.03 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $346.74 | Professional | None | $229.09 | $229.09 | $346.74 |
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 $123.03 Median $123.03 Typical High $128.82 | Professional | 52 · Reduced service | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | 53 · Discontinued | $50.12 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 54 · Surgery only | $186.21 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $25.70 |
Where Maryland sits
The same service costs 5.0 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· 49th of 51
$263
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.