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 $7.08 Median $7.08 Typical High $7.24 | Professional | None | $7.08 | $7.08 | $7.24 |
CareFirst Setting Professional Modifier None Typical Low $7.76 Median $8.51 Typical High $10.00 | Professional | None | $7.76 | $8.51 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $8.13 Typical High $15.14 | Professional | None | $7.08 | $8.13 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $13.49 | Professional | None | $7.59 | $8.71 | $13.49 |
United Setting Professional Modifier None Typical Low $6.92 Median $8.71 Typical High $17.78 | Professional | None | $6.92 | $8.71 | $17.78 |
Wellpoint Setting Professional Modifier None Typical Low $7.59 Median $10.96 Typical High $12.59 | Professional | None | $7.59 | $10.96 | $12.59 |
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 $3.55 Median $3.55 Typical High $3.63 | Professional | 52 · Reduced service | $3.55 | $3.55 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.41 Typical High $1.45 | Professional | 53 · Discontinued | $1.41 | $1.41 | $1.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | 54 · Surgery only | $5.25 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $0.72 |
Where Maryland sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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
$8.13
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.