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 $44.67 Median $60.26 Typical High $85.11 | Professional | None | $44.67 | $60.26 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $46.77 | Professional | None | $42.66 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $56.23 Typical High $93.33 | Facility | None | $48.98 | $56.23 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $147.91 | Professional | None | $42.66 | $79.43 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $144.54 | Professional | None | $83.18 | $97.72 | $144.54 |
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 $39.81 Median $77.62 Typical High $147.91 | Professional | None | $39.81 | $77.62 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $128.82 | Professional | None | $57.54 | $57.54 | $128.82 |
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 $22.39 Median $30.20 Typical High $42.66 | Professional | 52 · Reduced service | $22.39 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.02 Typical High $16.98 | Professional | 53 · Discontinued | $8.91 | $12.02 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $45.71 Typical High $63.10 | Professional | 54 · Surgery only | $33.11 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.12 Typical High $12.59 | Professional | 55 · Aftercare only | $6.61 | $9.12 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.03 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.47 | $6.03 | $8.51 |
Where Maryland sits
The same service costs 3.2 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· 49th of 51
$70.79
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.