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 $147.91 Median $537.03 Typical High $758.58 | Professional | None | $147.91 | $537.03 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | None | $114.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $389.05 Typical High $891.25 | Professional | None | $112.20 | $389.05 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $645.65 Typical High $870.96 | Professional | None | $239.88 | $645.65 | $870.96 |
United Setting Professional Modifier None Typical Low $114.82 Median $398.11 Typical High $1,096.48 | Professional | None | $114.82 | $398.11 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $912.01 | Professional | None | $446.68 | $446.68 | $912.01 |
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 $74.13 Median $263.03 Typical High $380.19 | Professional | 52 · Reduced service | $74.13 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $107.15 Typical High $151.36 | Professional | 53 · Discontinued | $29.51 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $398.11 Typical High $562.34 | Professional | 54 · Surgery only | $112.20 | $398.11 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $79.43 Typical High $114.82 | Professional | 55 · Aftercare only | $22.39 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $53.70 Typical High $75.86 | Professional | 56 · Pre-op care only | $14.79 | $53.70 | $75.86 |
Where Maryland sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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· 51st of 51
$214
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.