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 $316.23 Median $323.59 Typical High $323.59 | Professional | None | $316.23 | $323.59 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | None | $309.03 | $346.74 | $346.74 |
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 $281.84 Median $309.03 Typical High $575.44 | Professional | None | $281.84 | $309.03 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $562.34 | Professional | None | $302.00 | $346.74 | $562.34 |
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 $257.04 Median $309.03 Typical High $691.83 | Professional | None | $257.04 | $309.03 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $457.09 | Professional | None | $309.03 | $309.03 | $457.09 |
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 $158.49 Median $158.49 Typical High $162.18 | Professional | 52 · Reduced service | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $64.57 | Professional | 53 · Discontinued | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $245.47 | Professional | 54 · Surgery only | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $32.36 |
Where Maryland sits
The same service costs 4.5 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
$324
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.