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 $67.61 Median $69.18 Typical High $70.79 | Professional | None | $67.61 | $69.18 | $70.79 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | None | $69.18 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $1,174.90 | Facility | None | $331.13 | $660.69 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $144.54 | Professional | None | $63.10 | $66.07 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $117.49 | Professional | None | $69.18 | $77.62 | $117.49 |
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 $53.70 Median $70.79 Typical High $154.88 | Professional | None | $53.70 | $70.79 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $104.71 | Professional | None | $64.57 | $64.57 | $104.71 |
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 $33.88 Median $33.88 Typical High $34.67 | Professional | 52 · Reduced service | $33.88 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $14.13 | Professional | 53 · Discontinued | $13.80 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $52.48 | Professional | 54 · Surgery only | $51.29 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.08 |
Where Maryland sits
The same service costs 4.4 times more in Alaska than in New York. 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· 50th of 51
$70.79
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.