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 $32.36 Median $91.20 Typical High $123.03 | Professional | None | $32.36 | $91.20 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $36.31 | Professional | None | $30.20 | $33.88 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $93.33 Typical High $162.18 | Facility | None | $50.12 | $93.33 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $89.13 Typical High $204.17 | Professional | None | $30.20 | $89.13 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $190.55 | Professional | None | $93.33 | $125.89 | $190.55 |
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 $30.20 Median $85.11 Typical High $218.78 | Professional | None | $30.20 | $85.11 | $218.78 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | None | $85.11 | $85.11 | $169.82 |
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 $16.22 Median $38.02 Typical High $61.66 | Professional | 52 · Reduced service | $16.22 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $15.14 Typical High $24.55 | Professional | 53 · Discontinued | $6.46 | $15.14 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $57.54 Typical High $93.33 | Professional | 54 · Surgery only | $24.55 | $57.54 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $11.48 Typical High $18.62 | Professional | 55 · Aftercare only | $4.90 | $11.48 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $7.59 Typical High $12.30 | Professional | 56 · Pre-op care only | $3.24 | $7.59 | $12.30 |
Where Maryland sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 46th 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.