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 $31.62 Median $79.43 Typical High $125.89 | Professional | None | $31.62 | $79.43 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $46.77 | Professional | None | $30.20 | $33.11 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $97.72 | Facility | None | $50.12 | $60.26 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $79.43 Typical High $147.91 | Professional | None | $30.20 | $79.43 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $154.88 | Professional | None | $83.18 | $97.72 | $154.88 |
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 $34.67 Median $74.13 Typical High $154.88 | Professional | None | $34.67 | $74.13 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $128.82 | Professional | None | $69.18 | $69.18 | $128.82 |
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 $15.85 Median $34.67 Typical High $42.66 | Professional | 52 · Reduced service | $15.85 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $13.80 Typical High $17.38 | Professional | 53 · Discontinued | $6.31 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $51.29 Typical High $64.57 | Professional | 54 · Surgery only | $23.99 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $10.47 Typical High $12.88 | Professional | 55 · Aftercare only | $4.79 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.16 | $6.92 | $8.71 |
Where Maryland sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 49th of 51
$69.18
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.