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 $54.95 Median $107.15 Typical High $162.18 | Professional | None | $54.95 | $107.15 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | None | $53.70 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $588.84 | Facility | None | $64.57 | $100.00 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $190.55 | Professional | None | $53.70 | $102.33 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $177.83 | Professional | None | $107.15 | $125.89 | $177.83 |
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 $56.23 Median $104.71 Typical High $204.17 | Professional | None | $56.23 | $104.71 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $165.96 | Professional | None | $91.20 | $91.20 | $165.96 |
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 $27.54 Median $46.77 Typical High $54.95 | Professional | 52 · Reduced service | $27.54 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $18.62 Typical High $21.88 | Professional | 53 · Discontinued | $10.96 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $69.18 Typical High $81.28 | Professional | 54 · Surgery only | $40.74 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $8.32 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $9.33 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.50 | $9.33 | $10.96 |
Where Maryland sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 42nd of 51
$97.72
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.