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 $50.12 Median $69.18 Typical High $234.42 | Professional | None | $50.12 | $69.18 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $33.88 Typical High $117.49 | Professional | 52 · Reduced service | $24.55 | $33.88 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $13.80 Typical High $46.77 | Professional | 53 · Discontinued | $10.00 | $13.80 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.23 Typical High $35.48 | Professional | 55 · Aftercare only | $7.41 | $10.23 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.92 Typical High $23.44 | Professional | 56 · Pre-op care only | $5.01 | $6.92 | $23.44 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | None | $50.12 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $2,691.53 | Facility | None | $501.19 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $151.36 Typical High $281.84 | Professional | None | $47.86 | $151.36 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $416.87 | Professional | None | $218.78 | $251.19 | $416.87 |
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 $40.74 Median $128.82 Typical High $338.84 | Professional | None | $40.74 | $128.82 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $346.74 | Professional | None | $151.36 | $151.36 | $346.74 |
1 more rate 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 54 · Surgery only Typical Low $37.15 Median $51.29 Typical High $177.83 | Professional | 54 · Surgery only | $37.15 | $51.29 | $177.83 |
Where Maryland sits
The same service costs 4.6 times more in Iowa 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· 46th of 51
$85.11
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.