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 (both parts) Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None (both parts) | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $234.42 Median $245.47 Typical High $269.15 | Professional | 26 · Professional part | $234.42 | $245.47 | $269.15 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | None (both parts) | $263.03 | $295.12 | $295.12 |
CareFirst Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 26 · Professional part | $251.19 | $275.42 | $275.42 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $288.40 Typical High $776.25 | Professional | 26 · Professional part | $251.19 | $288.40 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $380.19 | Professional | None | $263.03 | $295.12 | $380.19 |
Kaiser Permanente Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $295.12 Typical High $380.19 | Professional | 26 · Professional part | $263.03 | $295.12 | $380.19 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None (both parts) Typical Low $234.42 Median $338.84 Typical High $588.84 | Professional | None (both parts) | $234.42 | $338.84 | $588.84 |
United Setting Professional Modifier 26 · Professional part Typical Low $234.42 Median $338.84 Typical High $588.84 | Professional | 26 · Professional part | $234.42 | $338.84 | $588.84 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $229.09 Typical High $398.11 | Professional | 26 · Professional part | $229.09 | $229.09 | $398.11 |
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 $117.49 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $24.55 |
Where Maryland sits
The same service costs 19.5 times more in Colorado than in Maryland. 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· 51st of 51
$347
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.