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 $97.72 Median $123.03 Typical High $165.96 | Facility | None | $97.72 | $123.03 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $165.96 | Professional | None | $97.72 | $123.03 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $154.88 | Professional | None | $114.82 | $120.23 | $154.88 |
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 $104.71 Median $131.83 Typical High $208.93 | Professional | None | $104.71 | $131.83 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $281.84 | Professional | None | $128.82 | $186.21 | $281.84 |
United Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $223.87 | Professional | None | $95.50 | $131.83 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | None | $138.04 | $173.78 | $173.78 |
6 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 $61.66 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $61.66 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $18.62 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $16.60 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $64.57 Median $123.03 Typical High $162.18 | Professional | AF · Specialist physician | $64.57 | $123.03 | $162.18 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $48.98 Median $93.33 Typical High $120.23 | Professional | HO · Master's level | $48.98 | $93.33 | $120.23 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $54.95 Median $104.71 Typical High $138.04 | Professional | TD · Registered nurse | $54.95 | $104.71 | $138.04 |
Where Maryland sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 45th of 51
$129
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.