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 (both parts) Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $75.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $38.90 Typical High $40.74 | Professional | 52 · Reduced service | $37.15 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.49 Typical High $16.22 | Professional | 53 · Discontinued | $15.14 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.48 Typical High $12.02 | Professional | 55 · Aftercare only | $11.22 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.76 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.59 | $7.76 | $8.13 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | None (both parts) | $77.62 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $83.18 Typical High $177.83 | Professional | None (both parts) | $70.79 | $83.18 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $120.23 | Professional | None | $48.98 | $75.86 | $120.23 |
United Setting Professional Modifier None (both parts) Typical Low $70.79 Median $102.33 Typical High $213.80 | Professional | None (both parts) | $70.79 | $102.33 | $213.80 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $79.43 Median $107.15 Typical High $109.65 | Professional | None (both parts) | $79.43 | $107.15 | $109.65 |
4 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 TC · Technical part Typical Low $77.62 Median $95.50 Typical High $131.83 | Professional | TC · Technical part | $77.62 | $95.50 | $131.83 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $114.82 Typical High $173.78 | Professional | TC · Technical part | $91.20 | $114.82 | $173.78 |
Kaiser Permanente Setting Professional Modifier TC · Technical part Typical Low $69.18 Median $72.44 Typical High $104.71 | Professional | TC · Technical part | $69.18 | $72.44 | $104.71 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 26 · Professional part | $72.44 | $72.44 | $72.44 |
Where Maryland sits
The same service costs 2.9 times more in Alaska 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· 50th 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.