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 $60.26 Median $114.82 Typical High $229.09 | Professional | None | $60.26 | $114.82 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $43.65 Typical High $114.82 | Professional | 52 · Reduced service | $30.20 | $43.65 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $46.77 | Professional | 53 · Discontinued | $12.02 | $17.38 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.88 Typical High $34.67 | Professional | 55 · Aftercare only | $8.91 | $12.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.71 Typical High $22.91 | Professional | 56 · Pre-op care only | $6.03 | $8.71 | $22.91 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | None | $63.10 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $134.90 Typical High $257.04 | Professional | None | $52.48 | $134.90 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $389.05 | Professional | None | $263.03 | $295.12 | $389.05 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $57.54 Median $134.90 Typical High $302.00 | Professional | None | $57.54 | $134.90 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $407.38 | Professional | None | $147.91 | $147.91 | $407.38 |
1 more rate 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 54 · Surgery only Typical Low $44.67 Median $64.57 Typical High $173.78 | Professional | 54 · Surgery only | $44.67 | $64.57 | $173.78 |
Where Maryland sits
The same service costs 4.7 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
$107
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.