How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Facility Modifier None Typical Low $346.74 Median $398.11 Typical High $2,187.76 | Facility | None | $346.74 | $398.11 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,445.44 Typical High $2,089.30 | Professional | None | $398.11 | $1,445.44 | $2,089.30 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | None | $316.23 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $912.01 Typical High $2,511.89 | Professional | None | $309.03 | $912.01 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,778.28 | $2,187.76 | $2,884.03 |
United Setting Professional Modifier None Typical Low $295.12 Median $1,258.93 Typical High $3,090.30 | Professional | None | $295.12 | $1,258.93 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $3,019.95 | Professional | None | $263.03 | $263.03 | $3,019.95 |
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 $199.53 Median $741.31 Typical High $1,047.13 | Professional | 52 · Reduced service | $199.53 | $741.31 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $295.12 Typical High $416.87 | Professional | 53 · Discontinued | $79.43 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,096.48 Typical High $1,584.89 | Professional | 54 · Surgery only | $302.00 | $1,096.48 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $218.78 Typical High $316.23 | Professional | 55 · Aftercare only | $60.26 | $218.78 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $147.91 Typical High $208.93 | Professional | 56 · Pre-op care only | $39.81 | $147.91 | $208.93 |
Where Maryland sits
The same service costs 5.6 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
$457
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.