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 $48.98 Median $83.18 Typical High $125.89 | Professional | None | $48.98 | $83.18 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $58.88 | Professional | None | $48.98 | $54.95 | $58.88 |
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 $47.86 Median $83.18 Typical High $169.82 | Professional | None | $47.86 | $83.18 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $147.91 | Professional | None | $87.10 | $102.33 | $147.91 |
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 $47.86 Median $95.50 Typical High $190.55 | Professional | None | $47.86 | $95.50 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $134.90 | Professional | None | $81.28 | $81.28 | $134.90 |
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 $24.55 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $24.55 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $14.45 Typical High $17.78 | Professional | 53 · Discontinued | $9.77 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $54.95 Typical High $67.61 | Professional | 54 · Surgery only | $36.31 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.96 Typical High $13.49 | Professional | 55 · Aftercare only | $7.24 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.90 | $7.24 | $8.91 |
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· 43rd of 51
$83.18
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.