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 $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
CareFirst Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | None | $89.13 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $416.87 Typical High $691.83 | Facility | None | $50.12 | $416.87 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $131.83 | Professional | None | $66.07 | $75.86 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $154.88 | Professional | None | $81.28 | $91.20 | $154.88 |
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 $58.88 Median $77.62 Typical High $169.82 | Professional | None | $58.88 | $77.62 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $39.81 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $60.26 Typical High $60.26 | Professional | 54 · Surgery only | $58.88 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $11.75 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $7.94 |
Where Maryland sits
The same service costs 5.5 times more in Arkansas 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· 39th of 51
$89.13
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.