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 $134.90 Median $144.54 Typical High $151.36 | Professional | None | $134.90 | $144.54 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | None | $128.82 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $229.09 | Professional | None | $123.03 | $151.36 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $263.03 | Professional | None | $138.04 | $158.49 | $263.03 |
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 $104.71 Median $134.90 Typical High $309.03 | Professional | None | $104.71 | $134.90 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $218.78 | Professional | None | $109.65 | $109.65 | $218.78 |
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 $66.07 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $66.07 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $26.92 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.49 | $14.45 | $14.45 |
Where Maryland sits
The same service costs 3.2 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· 35th of 51
$145
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.