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 $123.03 Median $190.55 Typical High $288.40 | Professional | None | $123.03 | $190.55 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $158.49 | Professional | None | $117.49 | $131.83 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $562.34 | Facility | None | $275.42 | $331.13 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $363.08 | Professional | None | $117.49 | $181.97 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $316.23 | Professional | None | $181.97 | $213.80 | $316.23 |
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 $114.82 Median $199.53 Typical High $346.74 | Professional | None | $114.82 | $199.53 | $346.74 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $281.84 | Professional | None | $134.90 | $134.90 | $281.84 |
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 $61.66 Median $72.44 Typical High $104.71 | Professional | 52 · Reduced service | $61.66 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.84 Typical High $42.66 | Professional | 53 · Discontinued | $24.55 | $28.84 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $109.65 Typical High $158.49 | Professional | 54 · Surgery only | $93.33 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $31.62 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.45 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.30 | $14.45 | $21.38 |
Where Maryland sits
The same service costs 3.2 times more in Wisconsin than in New York. 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· 44th of 51
$182
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.