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 $91.20 Median $208.93 Typical High $245.47 | Professional | None | $91.20 | $208.93 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | None | $93.33 | $104.71 | $104.71 |
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 $83.18 Median $177.83 Typical High $302.00 | Professional | None | $83.18 | $177.83 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $426.58 | Professional | None | $251.19 | $275.42 | $426.58 |
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 $70.79 Median $162.18 Typical High $380.19 | Professional | None | $70.79 | $162.18 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $389.05 | Professional | None | $181.97 | $181.97 | $389.05 |
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 $45.71 Median $53.70 Typical High $123.03 | Professional | 52 · Reduced service | $45.71 | $53.70 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $21.38 Typical High $48.98 | Professional | 53 · Discontinued | $18.20 | $21.38 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $81.28 Typical High $186.21 | Professional | 54 · Surgery only | $67.61 | $81.28 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.22 Typical High $37.15 | Professional | 55 · Aftercare only | $13.49 | $16.22 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.72 Typical High $24.55 | Professional | 56 · Pre-op care only | $9.12 | $10.72 | $24.55 |
Where Maryland sits
The same service costs 4.5 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· 44th of 51
$166
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.