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 $52.48 Median $107.15 Typical High $117.49 | Professional | None | $52.48 | $107.15 | $117.49 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $64.57 | Professional | None | $53.70 | $58.88 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $588.84 | Facility | None | $79.43 | $125.89 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $173.78 | Professional | None | $48.98 | $97.72 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $218.78 | Professional | None | $128.82 | $144.54 | $218.78 |
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 $51.29 Median $102.33 Typical High $204.17 | Professional | None | $51.29 | $102.33 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $199.53 | Professional | None | $112.20 | $112.20 | $199.53 |
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 $26.30 Median $51.29 Typical High $58.88 | Professional | 52 · Reduced service | $26.30 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $20.42 Typical High $23.44 | Professional | 53 · Discontinued | $10.47 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $77.62 Typical High $87.10 | Professional | 54 · Surgery only | $38.90 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $7.94 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $10.23 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.25 | $10.23 | $11.75 |
Where Maryland sits
The same service costs 3.2 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· 47th of 51
$100
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.