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 $41.69 Median $79.43 Typical High $85.11 | Professional | None | $41.69 | $79.43 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $48.98 | Professional | None | $43.65 | $47.86 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $588.84 | Facility | None | $43.65 | $69.18 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $75.86 Typical High $147.91 | Professional | None | $38.90 | $75.86 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $144.54 | Professional | None | $79.43 | $91.20 | $144.54 |
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 $40.74 Median $87.10 Typical High $173.78 | Professional | None | $40.74 | $87.10 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $123.03 | Professional | None | $79.43 | $79.43 | $123.03 |
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 $20.89 Median $37.15 Typical High $42.66 | Professional | 52 · Reduced service | $20.89 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $14.79 Typical High $16.98 | Professional | 53 · Discontinued | $8.51 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $56.23 Typical High $64.57 | Professional | 54 · Surgery only | $31.62 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $11.22 Typical High $12.88 | Professional | 55 · Aftercare only | $6.31 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.41 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.17 | $7.41 | $8.51 |
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· 46th of 51
$75.86
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.