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 $67.61 Median $85.11 Typical High $97.72 | Professional | None | $67.61 | $85.11 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | None | $64.57 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $588.84 | Facility | None | $43.65 | $69.18 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $199.53 | Professional | None | $66.07 | $93.33 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $169.82 | Professional | None | $95.50 | $112.20 | $169.82 |
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 $60.26 Median $100.00 Typical High $173.78 | Professional | None | $60.26 | $100.00 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $147.91 | Professional | None | $66.07 | $66.07 | $147.91 |
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 $33.88 Median $38.90 Typical High $48.98 | Professional | 52 · Reduced service | $33.88 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $13.49 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $57.54 Typical High $74.13 | Professional | 54 · Surgery only | $51.29 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $10.23 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.76 | $7.76 | $9.77 |
Where Maryland sits
The same service costs 3.5 times more in Wisconsin 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· 42nd of 51
$89.13
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.