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 $23.44 Median $30.90 Typical High $32.36 | Professional | None | $23.44 | $30.90 | $32.36 |
CareFirst Setting Professional Modifier None Typical Low $23.44 Median $25.70 Typical High $25.70 | Professional | None | $23.44 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $24.55 Typical High $602.56 | Facility | None | $15.14 | $24.55 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $29.51 Typical High $54.95 | Professional | None | $21.38 | $29.51 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $40.74 Typical High $60.26 | Professional | None | $35.48 | $40.74 | $60.26 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $19.05 Median $30.20 Typical High $64.57 | Professional | None | $19.05 | $30.20 | $64.57 |
Wellpoint Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $53.70 | Professional | None | $33.11 | $33.11 | $53.70 |
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 $11.75 Median $14.13 Typical High $16.22 | Professional | 52 · Reduced service | $11.75 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.62 Typical High $6.46 | Professional | 53 · Discontinued | $4.79 | $5.62 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $21.38 Typical High $24.55 | Professional | 54 · Surgery only | $17.78 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.27 Typical High $4.90 | Professional | 55 · Aftercare only | $3.55 | $4.27 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.82 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.34 | $2.82 | $3.24 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 51st of 51
$28.84
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.