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 $40.74 Median $138.04 Typical High $229.09 | Professional | None | $40.74 | $138.04 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $39.81 | Professional | None | $34.67 | $38.90 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $95.50 Typical High $295.12 | Professional | None | $35.48 | $95.50 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $281.84 | Professional | None | $128.82 | $204.17 | $281.84 |
United Setting Professional Modifier None Typical Low $35.48 Median $120.23 Typical High $338.84 | Professional | None | $35.48 | $120.23 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $288.40 | Professional | None | $125.89 | $125.89 | $288.40 |
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 $20.42 Median $74.13 Typical High $114.82 | Professional | 52 · Reduced service | $20.42 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $30.20 Typical High $45.71 | Professional | 53 · Discontinued | $8.13 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $112.20 Typical High $169.82 | Professional | 54 · Surgery only | $30.90 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $22.91 Typical High $33.88 | Professional | 55 · Aftercare only | $6.17 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $4.07 | $15.49 | $22.91 |
Where Maryland sits
The same service costs 4.5 times more in Wisconsin 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· 50th of 51
$64.57
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.