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 $64.57 Median $97.72 Typical High $125.89 | Professional | None | $64.57 | $97.72 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $60.26 | Professional | None | $52.48 | $57.54 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $2,691.53 | Facility | None | $501.19 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $158.49 | Professional | None | $51.29 | $87.10 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $165.96 | Professional | None | $87.10 | $104.71 | $165.96 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $204.17 | Professional | None | $53.70 | $102.33 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $141.25 | Professional | None | $85.11 | $85.11 | $141.25 |
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 $32.36 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $32.36 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $21.88 | Professional | 53 · Discontinued | $12.88 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $63.10 Typical High $83.18 | Professional | 54 · Surgery only | $47.86 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $10.96 |
Where Maryland sits
The same service costs 3.7 times more in Wisconsin than in Florida. 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· 44th of 51
$91.20
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.