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 $47.86 Median $97.72 Typical High $128.82 | Professional | None | $47.86 | $97.72 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | None | $50.12 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $95.50 Typical High $588.84 | Facility | None | $60.26 | $95.50 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $173.78 | Professional | None | $45.71 | $95.50 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $181.97 | Professional | None | $97.72 | $114.82 | $181.97 |
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 $44.67 Median $95.50 Typical High $204.17 | Professional | None | $44.67 | $95.50 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $151.36 | Professional | None | $93.33 | $93.33 | $151.36 |
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 $23.99 Median $39.81 Typical High $53.70 | Professional | 52 · Reduced service | $23.99 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $16.22 Typical High $21.38 | Professional | 53 · Discontinued | $9.55 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $60.26 Typical High $81.28 | Professional | 54 · Surgery only | $35.48 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.02 Typical High $16.22 | Professional | 55 · Aftercare only | $7.08 | $12.02 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.94 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.79 | $7.94 | $10.72 |
Where Maryland sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 36th of 51
$93.33
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.