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 $64.57 Median $131.83 Typical High $169.82 | Professional | None | $64.57 | $131.83 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $61.66 | Professional | None | $53.70 | $60.26 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $125.89 Typical High $218.78 | Professional | None | $50.12 | $125.89 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $338.84 | Professional | None | $144.54 | $173.78 | $338.84 |
United Setting Professional Modifier None Typical Low $56.23 Median $141.25 Typical High $269.15 | Professional | None | $56.23 | $141.25 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $245.47 | Professional | None | $138.04 | $138.04 | $245.47 |
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 $32.36 Median $36.31 Typical High $85.11 | Professional | 52 · Reduced service | $32.36 | $36.31 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $14.45 Typical High $34.67 | Professional | 53 · Discontinued | $12.88 | $14.45 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $54.95 Typical High $128.82 | Professional | 54 · Surgery only | $48.98 | $54.95 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.96 Typical High $25.70 | Professional | 55 · Aftercare only | $9.77 | $10.96 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.24 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.46 | $7.24 | $16.98 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 51st of 51
$83.18
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.