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 $173.78 Median $173.78 Typical High $177.83 | Professional | None | $173.78 | $173.78 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | None | $190.55 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $316.23 | Professional | None | $154.88 | $165.96 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $309.03 | Professional | None | $162.18 | $190.55 | $309.03 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $380.19 | Professional | None | $141.25 | $169.82 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $251.19 | Professional | None | $169.82 | $169.82 | $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 $87.10 Median $87.10 Typical High $89.13 | Professional | 52 · Reduced service | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $35.48 | Professional | 53 · Discontinued | $34.67 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 54 · Surgery only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.78 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.78 |
Where Maryland sits
The same service costs 4.4 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
$191
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.