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 $63.10 Median $125.89 Typical High $263.03 | Facility | None | $63.10 | $125.89 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $131.83 Typical High $204.17 | Professional | None | $61.66 | $131.83 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $97.72 | Professional | None | $77.62 | $87.10 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $588.84 | Facility | None | $100.00 | $158.49 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $281.84 | Professional | None | $69.18 | $144.54 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $281.84 | Professional | None | $162.18 | $186.21 | $281.84 |
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 $70.79 Median $151.36 Typical High $295.12 | Professional | None | $70.79 | $151.36 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $251.19 | Professional | None | $128.82 | $128.82 | $251.19 |
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 $30.90 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $30.90 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $12.59 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $77.62 Typical High $102.33 | Professional | 54 · Surgery only | $46.77 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.49 Typical High $20.42 | Professional | 55 · Aftercare only | $9.33 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.31 | $10.47 | $13.49 |
Where Maryland sits
The same service costs 3.3 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
$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.