How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $128.82 | Facility | None | $93.33 | $97.72 | $128.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $77.62 Median $81.28 Typical High $83.18 | Professional | None (both parts) | $77.62 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.49 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.76 | $8.13 | $8.13 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | None (both parts) | $72.44 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None (both parts) Typical Low $67.61 Median $83.18 Typical High $144.54 | Professional | None (both parts) | $67.61 | $83.18 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $131.83 | Professional | None | $77.62 | $93.33 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $25.70 Median $75.86 Typical High $158.49 | Professional | None (both parts) | $25.70 | $75.86 | $158.49 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $95.50 Median $128.82 Typical High $134.90 | Professional | None (both parts) | $95.50 | $128.82 | $134.90 |
1 more rate 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 |
|---|---|---|---|---|---|
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 26 · Professional part | $81.28 | $81.28 | $81.28 |
Where Maryland sits
The same service costs 2.9 times more in Alaska 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
$79.43
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.