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 $186.21 Median $537.03 Typical High $758.58 | Professional | None | $186.21 | $537.03 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | None | $144.54 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $389.05 Typical High $870.96 | Professional | None | $141.25 | $389.05 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $851.14 | Professional | None | $288.40 | $602.56 | $851.14 |
United Setting Professional Modifier None Typical Low $141.25 Median $426.58 Typical High $1,071.52 | Professional | None | $141.25 | $426.58 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $870.96 | Professional | None | $426.58 | $426.58 | $870.96 |
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 $93.33 Median $269.15 Typical High $380.19 | Professional | 52 · Reduced service | $93.33 | $269.15 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $107.15 Typical High $151.36 | Professional | 53 · Discontinued | $37.15 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $407.38 Typical High $562.34 | Professional | 54 · Surgery only | $141.25 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $81.28 Typical High $112.20 | Professional | 55 · Aftercare only | $28.18 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $53.70 Typical High $75.86 | Professional | 56 · Pre-op care only | $18.62 | $53.70 | $75.86 |
Where Maryland sits
The same service costs 3.5 times more in Wisconsin 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
$257
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.