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 $43.65 Median $47.86 Typical High $47.86 | Professional | None | $43.65 | $47.86 | $47.86 |
CareFirst Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | None | $50.12 | $54.95 | $54.95 |
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 $44.67 Median $54.95 Typical High $117.49 | Professional | None | $44.67 | $54.95 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $81.28 | Professional | None | $41.69 | $48.98 | $81.28 |
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 $42.66 Median $63.10 Typical High $117.49 | Professional | None | $42.66 | $63.10 | $117.49 |
Wellpoint Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $63.10 | Professional | None | $36.31 | $36.31 | $63.10 |
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 $21.88 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $21.88 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $8.71 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.37 | $4.79 | $4.79 |
Where Maryland sits
The same service costs 4.7 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· 45th of 51
$54.95
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.