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 $151.36 Median $151.36 Typical High $263.03 | Facility | None | $151.36 | $151.36 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $134.90 | Professional | None | $74.13 | $109.65 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | None | $69.18 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $213.80 | Professional | None | $70.79 | $114.82 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $186.21 | Professional | None | $104.71 | $138.04 | $186.21 |
United Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $234.42 | Professional | None | $66.07 | $112.20 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $190.55 | Professional | None | $79.43 | $79.43 | $190.55 |
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 $37.15 Median $45.71 Typical High $67.61 | Professional | 52 · Reduced service | $37.15 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $26.92 | Professional | 53 · Discontinued | $14.79 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $69.18 Typical High $100.00 | Professional | 54 · Surgery only | $56.23 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $19.95 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $13.49 |
Where Maryland sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$87.10
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.