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 $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | None | $218.78 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,348.96 Typical High $2,691.53 | Facility | None | $588.84 | $1,348.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $380.19 | Professional | None | $181.97 | $194.98 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $363.08 | Professional | None | $194.98 | $223.87 | $363.08 |
United Setting Facility Modifier None Typical Low $64.57 Median $151.36 Typical High $645.65 | Facility | None | $64.57 | $151.36 | $645.65 |
United Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $446.68 | Professional | None | $158.49 | $194.98 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $295.12 | Professional | None | $194.98 | $194.98 | $295.12 |
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 $102.33 Median $102.33 Typical High $104.71 | Professional | 52 · Reduced service | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 54 · Surgery only | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Where Maryland sits
The same service costs 5.1 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· 43rd of 51
$214
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.