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 $58.88 Median $251.19 Typical High $346.74 | Professional | None | $58.88 | $251.19 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $54.95 | Professional | None | $45.71 | $51.29 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $147.91 Typical High $446.68 | Professional | None | $43.65 | $147.91 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $537.03 | Professional | None | $186.21 | $295.12 | $537.03 |
United Setting Professional Modifier None Typical Low $43.65 Median $251.19 Typical High $602.56 | Professional | None | $43.65 | $251.19 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $407.38 | Professional | None | $251.19 | $251.19 | $407.38 |
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 $29.51 Median $125.89 Typical High $173.78 | Professional | 52 · Reduced service | $29.51 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $50.12 Typical High $69.18 | Professional | 53 · Discontinued | $11.75 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $186.21 Typical High $257.04 | Professional | 54 · Surgery only | $43.65 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $37.15 Typical High $52.48 | Professional | 55 · Aftercare only | $8.71 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $25.12 Typical High $34.67 | Professional | 56 · Pre-op care only | $5.89 | $25.12 | $34.67 |
Where Maryland sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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
$89.13
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.