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 $75.86 Median $97.72 Typical High $181.97 | Professional | None | $75.86 | $97.72 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | None | $72.44 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $165.96 Typical High $588.84 | Facility | None | $109.65 | $165.96 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $154.88 Typical High $295.12 | Professional | None | $74.13 | $154.88 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $281.84 | Professional | None | $177.83 | $204.17 | $281.84 |
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 $69.18 Median $144.54 Typical High $281.84 | Professional | None | $69.18 | $144.54 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $275.42 | Professional | None | $93.33 | $93.33 | $275.42 |
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 $38.02 Median $48.98 Typical High $91.20 | Professional | 52 · Reduced service | $38.02 | $48.98 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.50 Typical High $36.31 | Professional | 53 · Discontinued | $15.14 | $19.50 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $72.44 Typical High $138.04 | Professional | 54 · Surgery only | $56.23 | $72.44 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.45 Typical High $27.54 | Professional | 55 · Aftercare only | $11.22 | $14.45 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.77 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.59 | $9.77 | $18.20 |
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· 48th of 51
$126
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.