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 $83.18 Median $128.82 Typical High $239.88 | Professional | None | $83.18 | $128.82 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $138.04 | Professional | None | $102.33 | $112.20 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $120.23 Typical High $588.84 | Facility | None | $74.13 | $120.23 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $323.59 | Professional | None | $91.20 | $147.91 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $269.15 | Professional | None | $158.49 | $186.21 | $269.15 |
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 $95.50 Median $162.18 Typical High $295.12 | Professional | None | $95.50 | $162.18 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $245.47 | Professional | None | $134.90 | $134.90 | $245.47 |
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 $41.69 Median $61.66 Typical High $64.57 | Professional | 52 · Reduced service | $41.69 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $24.55 Typical High $26.30 | Professional | 53 · Discontinued | $16.60 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $91.20 Typical High $97.72 | Professional | 54 · Surgery only | $63.10 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $12.59 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.30 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.32 | $12.30 | $13.18 |
Where Maryland sits
The same service costs 3.2 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
$135
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.