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 $70.79 Median $162.18 Typical High $213.80 | Professional | None | $70.79 | $162.18 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | None | $69.18 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $165.96 Typical High $316.23 | Professional | None | $69.18 | $165.96 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $309.03 | Professional | None | $169.82 | $218.78 | $309.03 |
United Setting Professional Modifier None Typical Low $69.18 Median $162.18 Typical High $380.19 | Professional | None | $69.18 | $162.18 | $380.19 |
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 $35.48 Median $79.43 Typical High $107.15 | Professional | 52 · Reduced service | $35.48 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $32.36 Typical High $42.66 | Professional | 53 · Discontinued | $14.13 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $120.23 Typical High $158.49 | Professional | 54 · Surgery only | $52.48 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $23.99 Typical High $31.62 | Professional | 55 · Aftercare only | $10.47 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $15.85 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.08 | $15.85 | $21.38 |
Where Maryland sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 48th of 51
$132
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.