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 $269.15 Median $426.58 Typical High $3,019.95 | Professional | None | $269.15 | $426.58 | $3,019.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $223.87 Typical High $1,479.11 | Professional | 52 · Reduced service | $134.90 | $223.87 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $89.13 Typical High $602.56 | Professional | 53 · Discontinued | $53.70 | $89.13 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $66.07 Typical High $446.68 | Professional | 55 · Aftercare only | $39.81 | $66.07 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $44.67 Typical High $302.00 | Professional | 56 · Pre-op care only | $26.92 | $44.67 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $316.23 | Professional | None | $229.09 | $257.04 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $1,202.26 | Facility | None | $512.86 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $549.54 Typical High $2,691.53 | Professional | None | $234.42 | $549.54 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $4,168.69 | Professional | None | $2,137.96 | $3,019.95 | $4,168.69 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $218.78 Median $426.58 Typical High $3,548.13 | Professional | None | $218.78 | $426.58 | $3,548.13 |
Wellpoint Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,548.13 | Professional | None | $2,344.23 | $2,344.23 | $3,548.13 |
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 $199.53 Median $331.13 Typical High $2,238.72 | Professional | 54 · Surgery only | $199.53 | $331.13 | $2,238.72 |
Where Maryland sits
The same service costs 12.0 times more in Washington 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
$347
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.