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 $173.78 Median $177.83 Typical High $181.97 | Professional | None | $173.78 | $177.83 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $346.74 Typical High $2,691.53 | Facility | None | $316.23 | $346.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $316.23 | Professional | None | $158.49 | $165.96 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $316.23 | Professional | None | $151.36 | $173.78 | $316.23 |
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 $144.54 Median $169.82 Typical High $389.05 | Professional | None | $144.54 | $169.82 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $229.09 | Professional | None | $151.36 | $151.36 | $229.09 |
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 $87.10 Median $87.10 Typical High $89.13 | Professional | 52 · Reduced service | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 54 · Surgery only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $18.20 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $18.20 |
Where Maryland sits
The same service costs 5.5 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· 45th of 51
$182
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.