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 $40.74 Median $91.20 Typical High $158.49 | Professional | None | $40.74 | $91.20 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | None | $67.61 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $588.84 | Facility | None | $74.13 | $117.49 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $194.98 | Professional | None | $63.10 | $107.15 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $199.53 | Professional | None | $123.03 | $162.18 | $199.53 |
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 $42.66 Median $91.20 Typical High $186.21 | Professional | None | $42.66 | $91.20 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $213.80 | Professional | None | $74.13 | $74.13 | $213.80 |
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 $19.95 Median $27.54 Typical High $54.95 | Professional | 52 · Reduced service | $19.95 | $27.54 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.96 Typical High $21.88 | Professional | 53 · Discontinued | $8.13 | $10.96 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $40.74 Typical High $81.28 | Professional | 54 · Surgery only | $30.20 | $40.74 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.12 Typical High $16.22 | Professional | 55 · Aftercare only | $6.03 | $9.12 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.03 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.07 | $6.03 | $10.96 |
Where Maryland sits
The same service costs 3.5 times more in Minnesota 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· 35th of 51
$91.20
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.