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 $114.82 Median $117.49 Typical High $117.49 | Professional | None | $114.82 | $117.49 | $117.49 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $144.54 | Professional | None | $107.15 | $117.49 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $251.19 Typical High $436.52 | Facility | None | $158.49 | $251.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $295.12 | Professional | None | $102.33 | $141.25 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $213.80 | Professional | None | $102.33 | $117.49 | $213.80 |
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 $109.65 Median $165.96 Typical High $309.03 | Professional | None | $109.65 | $165.96 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | None | $102.33 | $102.33 | $154.88 |
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 $57.54 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $85.11 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.38 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.48 | $11.75 | $11.75 |
Where Maryland sits
The same service costs 3.9 times more in Wisconsin than in New York. 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
$132
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.