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 $38.90 Median $40.74 Typical High $48.98 | Professional | None | $38.90 | $40.74 | $48.98 |
CareFirst Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $36.31 | Professional | None | $32.36 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $1,659.59 | Facility | None | $478.63 | $602.56 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $34.67 Typical High $45.71 | Professional | None | $29.51 | $34.67 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $58.88 | Professional | None | $38.90 | $43.65 | $58.88 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $66.07 | Professional | None | $28.18 | $35.48 | $66.07 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $63.10 | Professional | None | $27.54 | $27.54 | $63.10 |
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 $19.50 Median $20.42 Typical High $24.55 | Professional | 52 · Reduced service | $19.50 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.13 Typical High $9.77 | Professional | 53 · Discontinued | $7.76 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $30.90 Typical High $36.31 | Professional | 54 · Surgery only | $28.84 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.17 Typical High $7.24 | Professional | 55 · Aftercare only | $5.75 | $6.17 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.89 | $4.07 | $4.90 |
Where Maryland sits
The same service costs 3.8 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
$37.15
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.