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 Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $144.54 | Facility | None | $79.43 | $79.43 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $91.20 | Professional | None | $39.81 | $74.13 | $91.20 |
CareFirst Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | None | $41.69 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $81.28 Typical High $588.84 | Facility | None | $51.29 | $81.28 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $66.07 Typical High $117.49 | Professional | None | $37.15 | $66.07 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $147.91 | Professional | None | $85.11 | $97.72 | $147.91 |
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 $39.81 Median $77.62 Typical High $144.54 | Professional | None | $39.81 | $77.62 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $134.90 | Professional | None | $75.86 | $75.86 | $134.90 |
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 $19.95 Median $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $19.95 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $7.94 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $48.98 Typical High $58.88 | Professional | 54 · Surgery only | $30.20 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $6.03 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.46 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.98 | $6.46 | $7.76 |
Where Maryland sits
The same service costs 3.5 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· 48th 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.