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 $89.13 Median $123.03 Typical High $144.54 | Professional | None | $89.13 | $123.03 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | None | $87.10 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $128.82 | Facility | None | $50.12 | $75.86 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $269.15 | Professional | None | $87.10 | $125.89 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $213.80 | Professional | None | $134.90 | $158.49 | $213.80 |
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 $79.43 Median $138.04 Typical High $257.04 | Professional | None | $79.43 | $138.04 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $208.93 | Professional | None | $97.72 | $97.72 | $208.93 |
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 $44.67 Median $53.70 Typical High $70.79 | Professional | 52 · Reduced service | $44.67 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $28.84 | Professional | 53 · Discontinued | $17.78 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $81.28 Typical High $107.15 | Professional | 54 · Surgery only | $67.61 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.22 Typical High $21.38 | Professional | 55 · Aftercare only | $13.49 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.72 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.91 | $10.72 | $14.45 |
Where Maryland sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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
$123
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.