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 $173.78 Median $323.59 Typical High $436.52 | Professional | None | $173.78 | $323.59 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $199.53 | Professional | None | $158.49 | $177.83 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $602.56 | Facility | None | $288.40 | $426.58 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $371.54 Typical High $691.83 | Professional | None | $169.82 | $371.54 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $741.31 | Professional | None | $389.05 | $446.68 | $741.31 |
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 $158.49 Median $389.05 Typical High $851.14 | Professional | None | $158.49 | $389.05 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
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 $87.10 Median $162.18 Typical High $218.78 | Professional | 52 · Reduced service | $87.10 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $34.67 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $245.47 Typical High $323.59 | Professional | 54 · Surgery only | $128.82 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $26.30 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $32.36 Typical High $43.65 | Professional | 56 · Pre-op care only | $17.38 | $32.36 | $43.65 |
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
$363
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.