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 $125.89 Median $128.82 Typical High $128.82 | Professional | None | $125.89 | $128.82 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | None | $97.72 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $660.69 | Facility | None | $288.40 | $457.09 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $2,344.23 Typical High $2,951.21 | Professional | None | $239.88 | $2,344.23 | $2,951.21 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $2,290.87 | Professional | None | $123.03 | $190.55 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $2,187.76 Median $3,090.30 Typical High $3,467.37 | Professional | None | $2,187.76 | $3,090.30 | $3,467.37 |
4 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 $63.10 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $12.88 |
Where Maryland sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 34th of 51
$245
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.