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 $67.61 Median $72.44 Typical High $72.44 | Professional | None | $67.61 | $72.44 | $72.44 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | None | $75.86 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $436.52 Typical High $1,659.59 | Facility | None | $316.23 | $436.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $177.83 | Professional | None | $67.61 | $83.18 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $74.13 Typical High $123.03 | Professional | None | $64.57 | $74.13 | $123.03 |
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 $63.10 Median $95.50 Typical High $177.83 | Professional | None | $63.10 | $95.50 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $95.50 | Professional | None | $54.95 | $54.95 | $95.50 |
4 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 $33.88 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.88 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $13.49 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.24 |
Where Maryland sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 42nd of 51
$85.11
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.