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 $107.15 Median $117.49 Typical High $295.12 | Facility | None | $107.15 | $117.49 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $239.88 | Professional | None | $85.11 | $181.97 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | None | $66.07 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $302.00 | Professional | None | $69.18 | $154.88 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $331.13 | Professional | None | $165.96 | $213.80 | $331.13 |
United Setting Professional Modifier None Typical Low $67.61 Median $173.78 Typical High $380.19 | Professional | None | $67.61 | $173.78 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $275.42 | Professional | None | $177.83 | $177.83 | $275.42 |
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 $42.66 Median $77.62 Typical High $112.20 | Professional | 52 · Reduced service | $42.66 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $16.98 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $64.57 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $22.91 Typical High $33.88 | Professional | 55 · Aftercare only | $12.88 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.51 | $15.49 | $22.39 |
Where Maryland sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 47th of 51
$135
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.