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 $64.57 Median $154.88 Typical High $208.93 | Professional | None | $64.57 | $154.88 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | None | $63.10 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $309.03 | Professional | None | $63.10 | $162.18 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $302.00 | Professional | None | $169.82 | $218.78 | $302.00 |
United Setting Professional Modifier None Typical Low $63.10 Median $158.49 Typical High $371.54 | Professional | None | $63.10 | $158.49 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $309.03 | Professional | None | $165.96 | $165.96 | $309.03 |
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 $32.36 Median $79.43 Typical High $104.71 | Professional | 52 · Reduced service | $32.36 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $31.62 Typical High $41.69 | Professional | 53 · Discontinued | $12.88 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $117.49 Typical High $154.88 | Professional | 54 · Surgery only | $47.86 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $9.77 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $15.85 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.46 | $15.85 | $20.89 |
Where Maryland sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 46th of 51
$123
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.