How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Facility Modifier None Typical Low $77.62 Median $104.71 Typical High $676.08 | Facility | None | $77.62 | $104.71 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $371.54 Typical High $537.03 | Professional | None | $75.86 | $371.54 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $75.86 | Professional | None | $67.61 | $74.13 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $218.78 Typical High $660.69 | Professional | None | $69.18 | $218.78 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $660.69 | Professional | None | $407.38 | $478.63 | $660.69 |
United Setting Professional Modifier None Typical Low $72.44 Median $288.40 Typical High $776.25 | Professional | None | $72.44 | $288.40 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $676.08 | Professional | None | $64.57 | $64.57 | $676.08 |
5 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 $38.02 Median $186.21 Typical High $269.15 | Professional | 52 · Reduced service | $38.02 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $74.13 Typical High $107.15 | Professional | 53 · Discontinued | $15.49 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $275.42 Typical High $398.11 | Professional | 54 · Surgery only | $57.54 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $56.23 Typical High $79.43 | Professional | 55 · Aftercare only | $11.48 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $37.15 Typical High $53.70 | Professional | 56 · Pre-op care only | $7.59 | $37.15 | $53.70 |
Where Maryland sits
The same service costs 5.6 times more in Wisconsin 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
$110
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.