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 Facility Modifier None Typical Low $35.48 Median $40.74 Typical High $50.12 | Facility | None | $35.48 | $40.74 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $53.70 | Professional | None | $40.74 | $42.66 | $53.70 |
CareFirst Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $37.15 | Professional | None | $33.11 | $37.15 | $37.15 |
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 $30.90 Median $36.31 Typical High $48.98 | Professional | None | $30.90 | $36.31 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $70.79 | Professional | None | $41.69 | $46.77 | $70.79 |
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 $26.30 Median $34.67 Typical High $69.18 | Professional | None | $26.30 | $34.67 | $69.18 |
Wellpoint Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $67.61 | Professional | None | $32.36 | $32.36 | $67.61 |
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 $20.42 Median $21.38 Typical High $26.92 | Professional | 52 · Reduced service | $20.42 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.51 Typical High $10.72 | Professional | 53 · Discontinued | $8.13 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $32.36 Typical High $39.81 | Professional | 54 · Surgery only | $30.20 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.46 Typical High $7.94 | Professional | 55 · Aftercare only | $6.03 | $6.46 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.27 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.07 | $4.27 | $5.37 |
Where Maryland sits
The same service costs 3.8 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
$38.90
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.