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 $74.13 Median $128.82 Typical High $154.88 | Professional | None | $74.13 | $128.82 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | None | $77.62 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $891.25 | Facility | None | $331.13 | $501.19 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $208.93 | Professional | None | $64.57 | $125.89 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $275.42 | Professional | None | $162.18 | $186.21 | $275.42 |
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 $114.82 Typical High $245.47 | Professional | None | $53.70 | $114.82 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $257.04 | Professional | None | $134.90 | $134.90 | $257.04 |
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 $37.15 Median $41.69 Typical High $77.62 | Professional | 52 · Reduced service | $37.15 | $41.69 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $16.98 Typical High $30.90 | Professional | 53 · Discontinued | $14.79 | $16.98 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $63.10 Typical High $114.82 | Professional | 54 · Surgery only | $54.95 | $63.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.59 Typical High $22.91 | Professional | 55 · Aftercare only | $10.96 | $12.59 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.32 Typical High $15.49 | Professional | 56 · Pre-op care only | $7.41 | $8.32 | $15.49 |
Where Maryland sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 45th of 51
$120
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.