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 $85.11 Median $128.82 Typical High $141.25 | Professional | None | $85.11 | $128.82 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | None | $87.10 | $95.50 | $95.50 |
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 $79.43 Median $120.23 Typical High $213.80 | Professional | None | $79.43 | $120.23 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $275.42 | Professional | None | $162.18 | $186.21 | $275.42 |
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 $77.62 Median $125.89 Typical High $251.19 | Professional | None | $77.62 | $125.89 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $251.19 | Professional | None | $141.25 | $141.25 | $251.19 |
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 $42.66 Median $56.23 Typical High $70.79 | Professional | 52 · Reduced service | $42.66 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $22.39 Typical High $28.18 | Professional | 53 · Discontinued | $16.98 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $85.11 Typical High $107.15 | Professional | 54 · Surgery only | $63.10 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $21.38 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.22 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.51 | $11.22 | $14.13 |
Where Maryland sits
The same service costs 4.3 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· 48th of 51
$126
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.