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 $208.93 Median $208.93 Typical High $213.80 | Professional | None | $208.93 | $208.93 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | None | $223.87 | $251.19 | $251.19 |
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 $169.82 Median $181.97 Typical High $380.19 | Professional | None | $169.82 | $181.97 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $263.03 | Professional | None | $173.78 | $181.97 | $263.03 |
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 $181.97 Median $213.80 Typical High $457.09 | Professional | None | $181.97 | $213.80 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $263.03 | Professional | None | $158.49 | $158.49 | $263.03 |
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 $104.71 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $41.69 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 54 · Surgery only | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $21.38 |
Where Maryland sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 40th of 51
$224
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.