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 Professional Modifier None Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | None | $3.63 | $3.72 | $3.72 |
CareFirst Setting Professional Modifier None Typical Low $3.55 Median $3.98 Typical High $3.98 | Professional | None | $3.55 | $3.98 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.63 Median $3.24 Typical High $6.46 | Facility | None | $2.63 | $3.24 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $2.95 Typical High $5.25 | Professional | None | $2.63 | $2.95 | $5.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $7.41 | Professional | None | $4.90 | $5.75 | $7.41 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.57 Typical High $3.63 | Professional | None | $2.24 | $2.57 | $3.63 |
Wellpoint Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $7.41 | Professional | None | $1.95 | $1.95 | $7.41 |
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 $1.82 Median $1.86 Typical High $1.86 | Professional | 52 · Reduced service | $1.82 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.74 Typical High $0.74 | Professional | 53 · Discontinued | $0.72 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.55 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $0.37 |
Where Maryland sits
The same service costs 3.6 times more in Mississippi than in Kentucky. 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· 35th of 51
$3.63
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.