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 $354.81 Median $389.05 Typical High $2,137.96 | Facility | None | $354.81 | $389.05 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,122.02 Typical High $1,698.24 | Professional | None | $281.84 | $1,122.02 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $275.42 | Professional | None | $223.87 | $245.47 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $602.56 Typical High $2,041.74 | Professional | None | $218.78 | $602.56 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $1,412.54 Typical High $1,949.84 | Professional | None | $416.87 | $1,412.54 | $1,949.84 |
United Setting Professional Modifier None Typical Low $218.78 Median $954.99 Typical High $2,691.53 | Professional | None | $218.78 | $954.99 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,047.13 | $1,995.26 |
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 $141.25 Median $602.56 Typical High $831.76 | Professional | 52 · Reduced service | $141.25 | $602.56 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $239.88 Typical High $338.84 | Professional | 53 · Discontinued | $56.23 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $912.01 Typical High $1,258.93 | Professional | 54 · Surgery only | $213.80 | $912.01 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $181.97 Typical High $251.19 | Professional | 55 · Aftercare only | $42.66 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $120.23 Typical High $169.82 | Professional | 56 · Pre-op care only | $28.18 | $120.23 | $169.82 |
Where Maryland sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 49th of 51
$437
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.