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 $38.02 Median $63.10 Typical High $117.49 | Professional | None | $38.02 | $63.10 | $117.49 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | None | $46.77 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $47.86 Typical High $66.07 | Facility | None | $33.88 | $47.86 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $144.54 | Professional | None | $41.69 | $70.79 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $131.83 | Professional | None | $74.13 | $87.10 | $131.83 |
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 $43.65 Median $79.43 Typical High $141.25 | Professional | None | $43.65 | $79.43 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $114.82 | Professional | None | $74.13 | $74.13 | $114.82 |
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 $19.05 Median $29.51 Typical High $31.62 | Professional | 52 · Reduced service | $19.05 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $11.75 Typical High $12.88 | Professional | 53 · Discontinued | $7.59 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $44.67 Typical High $47.86 | Professional | 54 · Surgery only | $28.18 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.91 Typical High $9.55 | Professional | 55 · Aftercare only | $5.62 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.80 | $5.89 | $6.46 |
Where Maryland sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 50th of 51
$66.07
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.