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 $47.86 Median $74.13 Typical High $87.10 | Professional | None | $47.86 | $74.13 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | None | $57.54 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $75.86 Typical High $588.84 | Facility | None | $47.86 | $75.86 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $181.97 | Professional | None | $51.29 | $87.10 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $162.18 | Professional | None | $97.72 | $114.82 | $162.18 |
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 $54.95 Median $100.00 Typical High $181.97 | Professional | None | $54.95 | $100.00 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $151.36 | Professional | None | $97.72 | $141.25 | $151.36 |
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 $23.99 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $23.99 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $9.55 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $53.70 Typical High $58.88 | Professional | 54 · Surgery only | $35.48 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.72 Typical High $11.75 | Professional | 55 · Aftercare only | $7.08 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.24 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.79 | $7.24 | $7.76 |
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· 49th of 51
$81.28
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.