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 $346.74 Median $354.81 Typical High $436.52 | Professional | None | $346.74 | $354.81 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | None | $426.58 | $467.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $1,202.26 | Professional | None | $371.54 | $457.09 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $707.95 | Professional | None | $331.13 | $389.05 | $707.95 |
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 $346.74 Median $524.81 Typical High $870.96 | Professional | None | $346.74 | $524.81 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $512.86 | Professional | None | $338.84 | $338.84 | $512.86 |
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 $173.78 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $173.78 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $70.79 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $263.03 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $40.74 |
Where Maryland sits
The same service costs 3.0 times more in Wisconsin than in Florida. 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
$427
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.