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 $85.11 Median $131.83 Typical High $151.36 | Professional | None | $85.11 | $131.83 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $93.33 | Professional | None | $77.62 | $87.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $338.84 Typical High $588.84 | Facility | None | $288.40 | $338.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $288.40 | Professional | None | $83.18 | $141.25 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $269.15 | Professional | None | $151.36 | $177.83 | $269.15 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $281.84 | Professional | None | $81.28 | $154.88 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $229.09 | Professional | None | $72.44 | $72.44 | $229.09 |
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 $42.66 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $42.66 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $16.98 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $64.57 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $19.50 Typical High $22.91 | Professional | 55 · Aftercare only | $12.88 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.51 | $12.88 | $15.14 |
Where Maryland sits
The same service costs 3.6 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· 35th of 51
$151
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.