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 $346.74 Median $346.74 Typical High $363.08 | Professional | None | $346.74 | $346.74 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | None | $281.84 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $630.96 Typical High $2,691.53 | Facility | None | $588.84 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $426.58 | Professional | None | $263.03 | $275.42 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $380.19 | Professional | None | $239.88 | $269.15 | $380.19 |
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 $251.19 Median $309.03 Typical High $645.65 | Professional | None | $251.19 | $309.03 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $371.54 | Professional | None | $245.47 | $245.47 | $371.54 |
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 $169.82 Median $169.82 Typical High $181.97 | Professional | 52 · Reduced service | $169.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 53 · Discontinued | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | 54 · Surgery only | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $36.31 |
Where Maryland sits
The same service costs 5.0 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· 48th of 51
$309
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.