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 $22.91 Median $26.30 Typical High $31.62 | Professional | None | $22.91 | $26.30 | $31.62 |
CareFirst Setting Professional Modifier None Typical Low $21.88 Median $23.99 Typical High $23.99 | Professional | None | $21.88 | $23.99 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $354.81 | Facility | None | $50.12 | $50.12 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $21.38 Typical High $50.12 | Professional | None | $16.98 | $21.38 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.50 Median $21.38 Typical High $30.90 | Professional | None | $19.50 | $21.38 | $30.90 |
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 $24.55 Median $40.74 Typical High $61.66 | Professional | None | $24.55 | $40.74 | $61.66 |
Wellpoint Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $30.20 | Professional | None | $19.05 | $19.05 | $30.20 |
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 $11.48 Median $12.02 Typical High $13.80 | Professional | 52 · Reduced service | $11.48 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.79 Typical High $5.62 | Professional | 53 · Discontinued | $4.57 | $4.79 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $18.20 Typical High $20.89 | Professional | 54 · Surgery only | $17.38 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.63 Typical High $4.17 | Professional | 55 · Aftercare only | $3.47 | $3.63 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.40 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.29 | $2.40 | $2.75 |
Where Maryland sits
The same service costs 4.3 times more in Wyoming 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· 47th of 51
$26.30
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.