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 Facility Modifier None Typical Low $30.20 Median $46.77 Typical High $74.13 | Facility | None | $30.20 | $46.77 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $38.90 Typical High $54.95 | Professional | None | $25.12 | $38.90 | $54.95 |
CareFirst Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $52.48 | Professional | None | $28.84 | $31.62 | $52.48 |
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 $26.92 Median $44.67 Typical High $58.88 | Professional | None | $26.92 | $44.67 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $40.74 Median $63.10 Typical High $93.33 | Professional | None | $40.74 | $63.10 | $93.33 |
United Setting Professional Modifier None Typical Low $19.50 Median $33.11 Typical High $60.26 | Professional | None | $19.50 | $33.11 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $36.31 Median $58.88 Typical High $58.88 | Professional | None | $36.31 | $58.88 | $58.88 |
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 52 · Reduced service Typical Low $16.22 Median $16.98 Typical High $27.54 | Professional | 52 · Reduced service | $16.22 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.25 Typical High $8.32 | Professional | 55 · Aftercare only | $4.90 | $5.25 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.39 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.24 | $3.39 | $5.62 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $32.36 Median $33.11 Typical High $54.95 | Professional | AF · Specialist physician | $32.36 | $33.11 | $54.95 |
Where Maryland sits
The same service costs 2.4 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· 47th of 51
$36.31
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.