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 $426.58 Median $1,949.84 Typical High $2,754.23 | Professional | None | $426.58 | $1,949.84 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $371.54 | Professional | None | $331.13 | $363.08 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $891.25 Typical High $3,388.44 | Professional | None | $323.59 | $891.25 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,290.87 | $3,162.28 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,778.28 Typical High $4,466.84 | Professional | None | $338.84 | $1,778.28 | $4,466.84 |
Wellpoint Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,949.84 | $1,949.84 | $3,162.28 |
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 $208.93 Median $977.24 Typical High $1,348.96 | Professional | 52 · Reduced service | $208.93 | $977.24 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $389.05 Typical High $549.54 | Professional | 53 · Discontinued | $85.11 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $1,479.11 Typical High $2,041.74 | Professional | 54 · Surgery only | $316.23 | $1,479.11 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $295.12 Typical High $407.38 | Professional | 55 · Aftercare only | $63.10 | $295.12 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $194.98 Typical High $275.42 | Professional | 56 · Pre-op care only | $42.66 | $194.98 | $275.42 |
Where Maryland sits
The same service costs 6.9 times more in Wisconsin 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· 50th of 51
$617
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.