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 $177.83 Median $354.81 Typical High $2,884.03 | Professional | None | $177.83 | $354.81 | $2,884.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $147.91 Typical High $1,445.44 | Professional | 52 · Reduced service | $89.13 | $147.91 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $58.88 Typical High $575.44 | Professional | 53 · Discontinued | $35.48 | $58.88 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $44.67 Typical High $436.52 | Professional | 55 · Aftercare only | $26.30 | $44.67 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $29.51 Typical High $288.40 | Professional | 56 · Pre-op care only | $17.78 | $29.51 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $186.21 | Professional | None | $134.90 | $151.36 | $186.21 |
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 $158.49 Median $371.54 Typical High $2,570.40 | Professional | None | $158.49 | $371.54 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,041.74 | $2,884.03 | $3,981.07 |
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 $147.91 Median $263.03 Typical High $3,467.37 | Professional | None | $147.91 | $263.03 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,238.72 | $3,388.44 |
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 $131.83 Median $223.87 Typical High $2,187.76 | Professional | 54 · Surgery only | $131.83 | $223.87 | $2,187.76 |
Where Maryland sits
The same service costs 17.4 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
$229
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.