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 $141.25 Median $218.78 Typical High $263.03 | Professional | None | $141.25 | $218.78 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | None | $128.82 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $436.52 | Facility | None | $128.82 | $213.80 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $436.52 | Professional | None | $138.04 | $234.42 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $398.11 | Professional | None | $263.03 | $309.03 | $398.11 |
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 $125.89 Median $239.88 Typical High $436.52 | Professional | None | $125.89 | $239.88 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $416.87 | Professional | None | $169.82 | $169.82 | $416.87 |
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 $70.79 Median $97.72 Typical High $131.83 | Professional | 52 · Reduced service | $70.79 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $39.81 Typical High $52.48 | Professional | 53 · Discontinued | $28.18 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $147.91 Typical High $199.53 | Professional | 54 · Surgery only | $107.15 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $29.51 Typical High $39.81 | Professional | 55 · Aftercare only | $21.38 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.95 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.13 | $19.95 | $26.30 |
Where Maryland sits
The same service costs 3.1 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
$195
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.