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 $120.23 Median $125.89 Typical High $147.91 | Professional | None | $120.23 | $125.89 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $354.81 | Facility | None | $50.12 | $50.12 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $134.90 | Professional | None | $91.20 | $102.33 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $194.98 | Professional | None | $114.82 | $134.90 | $194.98 |
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 $79.43 Median $97.72 Typical High $204.17 | Professional | None | $79.43 | $97.72 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $190.55 | Professional | None | $89.13 | $89.13 | $190.55 |
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 $60.26 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $60.26 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $29.51 | Professional | 53 · Discontinued | $23.99 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $95.50 Typical High $109.65 | Professional | 54 · Surgery only | $89.13 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $14.79 |
Where Maryland sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 46th of 51
$112
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.