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 $77.62 Median $131.83 Typical High $144.54 | Professional | None | $77.62 | $131.83 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | None | $77.62 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $933.25 | Facility | None | $446.68 | $537.03 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $208.93 | Professional | None | $69.18 | $117.49 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $263.03 | Professional | None | $154.88 | $177.83 | $263.03 |
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 $75.86 Median $138.04 Typical High $263.03 | Professional | None | $75.86 | $138.04 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $239.88 | Professional | None | $134.90 | $134.90 | $239.88 |
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 $38.90 Median $53.70 Typical High $72.44 | Professional | 52 · Reduced service | $38.90 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $21.38 Typical High $28.84 | Professional | 53 · Discontinued | $15.49 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $79.43 Typical High $107.15 | Professional | 54 · Surgery only | $57.54 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.85 Typical High $21.88 | Professional | 55 · Aftercare only | $11.48 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.72 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.76 | $10.72 | $14.45 |
Where Maryland sits
The same service costs 3.9 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· 47th of 51
$123
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.