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 $389.05 Median $457.09 Typical High $2,754.23 | Facility | None | $389.05 | $457.09 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $1,584.89 Typical High $2,691.53 | Professional | None | $457.09 | $1,584.89 | $2,691.53 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | None | $354.81 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $1,023.29 Typical High $3,162.28 | Professional | None | $346.74 | $1,023.29 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,754.23 | $3,715.35 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,380.38 Typical High $3,981.07 | Professional | None | $331.13 | $1,380.38 | $3,981.07 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $3,890.45 | Professional | None | $295.12 | $295.12 | $3,890.45 |
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 $223.87 Median $870.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $223.87 | $870.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $346.74 Typical High $537.03 | Professional | 53 · Discontinued | $91.20 | $346.74 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $1,288.25 Typical High $1,995.26 | Professional | 54 · Surgery only | $338.84 | $1,288.25 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $263.03 Typical High $407.38 | Professional | 55 · Aftercare only | $67.61 | $263.03 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $173.78 Typical High $269.15 | Professional | 56 · Pre-op care only | $45.71 | $173.78 | $269.15 |
Where Maryland sits
The same service costs 6.2 times more in Washington 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
$513
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.