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 $97.72 Median $295.12 Typical High $416.87 | Professional | None | $97.72 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $138.04 Typical High $208.93 | Professional | 52 · Reduced service | $48.98 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $54.95 Typical High $83.18 | Professional | 53 · Discontinued | $19.50 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $41.69 Typical High $63.10 | Professional | 55 · Aftercare only | $14.79 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $27.54 Typical High $41.69 | Professional | 56 · Pre-op care only | $9.77 | $27.54 | $41.69 |
CareFirst Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $109.65 | Professional | None | $81.28 | $91.20 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $776.25 | Facility | None | $128.82 | $213.80 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $234.42 Typical High $407.38 | Professional | None | $85.11 | $234.42 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $602.56 | Professional | None | $302.00 | $436.52 | $602.56 |
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 $75.86 Median $245.47 Typical High $489.78 | Professional | None | $75.86 | $245.47 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $512.86 | Professional | None | $295.12 | $295.12 | $512.86 |
1 more rate 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 54 · Surgery only Typical Low $74.13 Median $208.93 Typical High $316.23 | Professional | 54 · Surgery only | $74.13 | $208.93 | $316.23 |
Where Maryland sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 50th of 51
$115
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.