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 $144.54 Median $218.78 Typical High $338.84 | Professional | None | $144.54 | $218.78 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | None | $125.89 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $602.56 | Facility | None | $199.53 | $323.59 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $501.19 | Professional | None | $134.90 | $269.15 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $501.19 | Professional | None | $288.40 | $338.84 | $501.19 |
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 $125.89 Median $269.15 Typical High $537.03 | Professional | None | $125.89 | $269.15 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $446.68 | Professional | None | $208.93 | $208.93 | $446.68 |
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 $72.44 Median $102.33 Typical High $169.82 | Professional | 52 · Reduced service | $72.44 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $40.74 Typical High $69.18 | Professional | 53 · Discontinued | $28.84 | $40.74 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $151.36 Typical High $257.04 | Professional | 54 · Surgery only | $109.65 | $151.36 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $30.20 Typical High $51.29 | Professional | 55 · Aftercare only | $21.88 | $30.20 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $33.88 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $33.88 |
Where Maryland sits
The same service costs 3.2 times more in Wisconsin 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· 50th of 51
$224
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.