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 $45.71 Median $45.71 Typical High $47.86 | Professional | None | $45.71 | $45.71 | $47.86 |
CareFirst Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $41.69 | Professional | None | $36.31 | $40.74 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $426.58 | Facility | None | $50.12 | $50.12 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $77.62 | Professional | None | $36.31 | $41.69 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $93.33 | Professional | None | $39.81 | $44.67 | $93.33 |
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 $36.31 Median $46.77 Typical High $104.71 | Professional | None | $36.31 | $46.77 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | None | $37.15 | $37.15 | $60.26 |
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 $22.91 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $34.67 | Professional | 54 · Surgery only | $33.88 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.57 |
Where Maryland sits
The same service costs 13.8 times more in Oklahoma than in New York. 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· 49th of 51
$45.71
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.