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 $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $128.82 | Professional | None | $72.44 | $93.33 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $77.62 | Professional | None | $51.29 | $53.70 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $147.91 | Professional | None | $67.61 | $91.20 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $177.83 | Professional | None | $91.20 | $117.49 | $177.83 |
United Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $169.82 | Professional | None | $74.13 | $104.71 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | None | $89.13 | $117.49 | $117.49 |
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 $42.66 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $42.66 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $12.88 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.51 | $9.77 | $12.88 |
Where Maryland sits
The same service costs 2.5 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· 50th of 51
$87.10
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.