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 $79.43 Median $97.72 Typical High $131.83 | Professional | None | $79.43 | $97.72 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $83.18 | Professional | None | $69.18 | $75.86 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $208.93 | Professional | None | $70.79 | $117.49 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $181.97 | Professional | None | $123.03 | $141.25 | $181.97 |
United Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $251.19 | Professional | None | $72.44 | $123.03 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $186.21 | Professional | None | $169.82 | $177.83 | $186.21 |
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 $39.81 Median $48.98 Typical High $66.07 | Professional | 52 · Reduced service | $39.81 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $15.85 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.45 Typical High $19.95 | Professional | 55 · Aftercare only | $12.02 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.94 | $9.77 | $13.18 |
Where Maryland sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 49th of 51
$105
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.