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 $229.09 Median $794.33 Typical High $1,047.13 | Professional | None | $229.09 | $794.33 | $1,047.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $398.11 Typical High $524.81 | Professional | 52 · Reduced service | $114.82 | $398.11 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | None | $199.53 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $537.03 Typical High $1,348.96 | Professional | None | $204.17 | $537.03 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,288.25 | Professional | None | $812.83 | $977.24 | $1,288.25 |
United Setting Professional Modifier None Typical Low $194.98 Median $691.83 Typical High $1,698.24 | Professional | None | $194.98 | $691.83 | $1,698.24 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $1,348.96 | Professional | None | $186.21 | $186.21 | $1,348.96 |
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 53 · Discontinued Typical Low $45.71 Median $162.18 Typical High $208.93 | Professional | 53 · Discontinued | $45.71 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $602.56 Typical High $776.25 | Professional | 54 · Surgery only | $173.78 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $34.67 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $81.28 Typical High $104.71 | Professional | 56 · Pre-op care only | $22.91 | $81.28 | $104.71 |
Where Maryland sits
The same service costs 5.4 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
$282
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.