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 $138.04 Median $288.40 Typical High $338.84 | Professional | None | $138.04 | $288.40 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $162.18 | Professional | None | $134.90 | $151.36 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $269.15 Typical High $524.81 | Professional | None | $128.82 | $269.15 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $537.03 | Professional | None | $302.00 | $398.11 | $537.03 |
United Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $676.08 | Professional | None | $147.91 | $316.23 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $562.34 | Professional | None | $138.04 | $138.04 | $562.34 |
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 $69.18 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $69.18 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $27.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $104.71 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $42.66 Typical High $51.29 | Professional | 55 · Aftercare only | $20.89 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.80 | $28.84 | $33.88 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 50th of 51
$200
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.