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 $10.96 Median $11.75 Typical High $11.75 | Professional | None | $10.96 | $11.75 | $11.75 |
CareFirst Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $14.45 | Professional | None | $12.88 | $14.45 | $14.45 |
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 $11.22 Median $13.49 Typical High $29.51 | Professional | None | $11.22 | $13.49 | $29.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.96 Median $12.30 Typical High $20.42 | Professional | None | $10.96 | $12.30 | $20.42 |
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 $10.72 Median $16.60 Typical High $29.51 | Professional | None | $10.72 | $16.60 | $29.51 |
Wellpoint Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $16.22 | Professional | None | $9.55 | $9.55 | $16.22 |
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 $5.50 Median $5.89 Typical High $5.89 | Professional | 52 · Reduced service | $5.50 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.34 Typical High $2.34 | Professional | 53 · Discontinued | $2.19 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.78 Typical High $1.78 | Professional | 55 · Aftercare only | $1.62 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.10 | $1.17 | $1.17 |
Where Maryland sits
The same service costs 12.3 times more in Florida 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· 44th of 51
$14.45
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.