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 $58.88 Median $61.66 Typical High $61.66 | Professional | None | $58.88 | $61.66 | $61.66 |
CareFirst Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | None | $61.66 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $933.25 | Facility | None | $331.13 | $501.19 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $134.90 | Professional | None | $57.54 | $66.07 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $107.15 | Professional | None | $63.10 | $69.18 | $107.15 |
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 $54.95 Median $79.43 Typical High $154.88 | Professional | None | $54.95 | $79.43 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $95.50 | Professional | None | $63.10 | $63.10 | $95.50 |
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 $29.51 Median $29.51 Typical High $30.20 | Professional | 52 · Reduced service | $29.51 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | 54 · Surgery only | $44.67 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.17 |
Where Maryland sits
The same service costs 4.0 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· 49th of 51
$69.18
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.