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 $309.03 Median $1,096.48 Typical High $1,698.24 | Professional | None | $309.03 | $1,096.48 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | None | $239.88 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $741.31 Typical High $2,137.96 | Professional | None | $234.42 | $741.31 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,513.56 | $1,862.09 | $2,454.71 |
United Setting Professional Modifier None Typical Low $229.09 Median $954.99 Typical High $2,691.53 | Professional | None | $229.09 | $954.99 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $2,630.27 | Professional | None | $190.55 | $190.55 | $2,630.27 |
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 $151.36 Median $602.56 Typical High $851.14 | Professional | 52 · Reduced service | $151.36 | $602.56 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $239.88 Typical High $338.84 | Professional | 53 · Discontinued | $61.66 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $891.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $229.09 | $891.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $177.83 Typical High $257.04 | Professional | 55 · Aftercare only | $45.71 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $120.23 Typical High $169.82 | Professional | 56 · Pre-op care only | $30.90 | $120.23 | $169.82 |
Where Maryland sits
The same service costs 6.5 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
$331
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.