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 $38.90 Median $63.10 Typical High $100.00 | Facility | None | $38.90 | $63.10 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $70.79 | Professional | None | $33.88 | $50.12 | $70.79 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $67.61 | Professional | None | $39.81 | $42.66 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $186.21 | Facility | None | $120.23 | $141.25 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $91.20 | Professional | None | $36.31 | $56.23 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $120.23 | Professional | None | $54.95 | $79.43 | $120.23 |
United Setting Professional Modifier None Typical Low $38.02 Median $57.54 Typical High $95.50 | Professional | None | $38.02 | $57.54 | $95.50 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $75.86 | Professional | None | $48.98 | $75.86 | $75.86 |
3 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 $21.88 Median $27.54 Typical High $35.48 | Professional | 52 · Reduced service | $21.88 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.13 Typical High $10.72 | Professional | 55 · Aftercare only | $6.61 | $8.13 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.50 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.37 | $5.50 | $7.08 |
Where Maryland sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 49th of 51
$50.12
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.