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 $354.81 Median $354.81 Typical High $363.08 | Professional | None | $354.81 | $354.81 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | None | $346.74 | $389.05 | $389.05 |
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 $316.23 Median $346.74 Typical High $645.65 | Professional | None | $316.23 | $346.74 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $630.96 | Professional | None | $323.59 | $371.54 | $630.96 |
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 $295.12 Median $346.74 Typical High $776.25 | Professional | None | $295.12 | $346.74 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
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 $177.83 Median $177.83 Typical High $181.97 | Professional | 52 · Reduced service | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | 53 · Discontinued | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 54 · Surgery only | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $36.31 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $36.31 |
Where Maryland sits
The same service costs 4.9 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· 47th of 51
$355
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.