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 $104.71 Median $154.88 Typical High $177.83 | Professional | None | $104.71 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $52.48 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $20.89 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.88 Typical High $26.92 | Professional | 55 · Aftercare only | $15.49 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.47 | $14.79 | $17.78 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $97.72 | Professional | None | $72.44 | $81.28 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $1,659.59 | Facility | None | $426.58 | $602.56 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $208.93 | Professional | None | $91.20 | $144.54 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $263.03 | Professional | None | $141.25 | $190.55 | $263.03 |
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 $83.18 Median $128.82 Typical High $234.42 | Professional | None | $83.18 | $128.82 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $223.87 | Professional | None | $107.15 | $107.15 | $223.87 |
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 $77.62 Median $109.65 Typical High $134.90 | Professional | 54 · Surgery only | $77.62 | $109.65 | $134.90 |
Where Maryland sits
The same service costs 3.5 times more in Wyoming than in Maryland. 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· 51st of 51
$107
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.