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 Facility Modifier None Typical Low $102.33 Median $131.83 Typical High $218.78 | Facility | None | $102.33 | $131.83 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $251.19 | Professional | None | $100.00 | $151.36 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $147.91 | Professional | None | $123.03 | $138.04 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $144.54 Typical High $588.84 | Facility | None | $91.20 | $144.54 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $371.54 | Professional | None | $112.20 | $177.83 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $316.23 | Professional | None | $194.98 | $223.87 | $316.23 |
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 $114.82 Median $190.55 Typical High $346.74 | Professional | None | $114.82 | $190.55 | $346.74 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $295.12 | Professional | None | $154.88 | $154.88 | $295.12 |
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 $50.12 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $50.12 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $24.55 Typical High $30.20 | Professional | 53 · Discontinued | $19.95 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $107.15 Typical High $114.82 | Professional | 54 · Surgery only | $74.13 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $22.91 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $15.14 |
Where Maryland sits
The same service costs 3.7 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· 48th of 51
$166
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.