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 $53.70 Median $89.13 Typical High $141.25 | Professional | None | $53.70 | $89.13 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | None | $66.07 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $87.10 Typical High $588.84 | Facility | None | $54.95 | $87.10 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $208.93 | Professional | None | $60.26 | $97.72 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $181.97 | Professional | None | $112.20 | $131.83 | $181.97 |
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 $61.66 Median $104.71 Typical High $194.98 | Professional | None | $61.66 | $104.71 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $173.78 | Professional | None | $87.10 | $87.10 | $173.78 |
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 $26.92 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $26.92 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $10.72 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $66.07 | Professional | 54 · Surgery only | $39.81 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.30 Typical High $13.18 | Professional | 55 · Aftercare only | $8.13 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.37 | $8.32 | $8.91 |
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· 47th of 51
$93.33
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.