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 $87.10 Median $89.13 Typical High $89.13 | Professional | None | $87.10 | $89.13 | $89.13 |
CareFirst Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | None | $91.20 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $229.09 | Professional | None | $81.28 | $107.15 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $154.88 | Professional | None | $87.10 | $95.50 | $154.88 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $223.87 | Professional | None | $79.43 | $117.49 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $125.89 | Professional | None | $83.18 | $83.18 | $125.89 |
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 $43.65 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $43.65 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 54 · Surgery only | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.71 | $8.91 | $8.91 |
Where Maryland sits
The same service costs 4.5 times more in Wisconsin than in Utah. 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· 44th of 51
$100
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.