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 $33.88 Median $45.71 Typical High $79.43 | Professional | None | $33.88 | $45.71 | $79.43 |
CareFirst Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $67.61 | Professional | None | $41.69 | $43.65 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $85.11 | Professional | None | $38.02 | $52.48 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $70.79 | Professional | None | $44.67 | $52.48 | $70.79 |
United Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $89.13 | Professional | None | $30.20 | $50.12 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
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 Facility Modifier TD · Registered nurse Typical Low $38.90 Median $38.90 Typical High $44.67 | Facility | TD · Registered nurse | $38.90 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 52 · Reduced service | $22.91 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.68 |
Where Maryland sits
The same service costs 2.7 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· 39th of 51
$45.71
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.