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 $56.23 Median $60.26 Typical High $79.43 | Professional | None | $56.23 | $60.26 | $79.43 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | None | $46.77 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $42.66 Typical High $66.07 | Facility | None | $30.20 | $42.66 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $70.79 | Professional | None | $43.65 | $54.95 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $104.71 | Professional | None | $61.66 | $69.18 | $104.71 |
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 $41.69 Median $52.48 Typical High $102.33 | Professional | None | $41.69 | $52.48 | $102.33 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $100.00 | Professional | None | $48.98 | $48.98 | $100.00 |
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 $27.54 Median $29.51 Typical High $38.90 | Professional | 52 · Reduced service | $27.54 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.02 Typical High $15.85 | Professional | 53 · Discontinued | $11.22 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $44.67 Typical High $58.88 | Professional | 54 · Surgery only | $41.69 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.91 Typical High $11.75 | Professional | 55 · Aftercare only | $8.32 | $8.91 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.03 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.62 | $6.03 | $7.76 |
Where Maryland sits
The same service costs 3.7 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· 48th of 51
$54.95
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.