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 $181.97 Median $213.80 Typical High $363.08 | Professional | None | $181.97 | $213.80 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $204.17 | Professional | None | $181.97 | $199.53 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $181.97 Typical High $588.84 | Facility | None | $120.23 | $181.97 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $323.59 | Professional | None | $177.83 | $208.93 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $416.87 | Professional | None | $234.42 | $263.03 | $416.87 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $446.68 | Professional | None | $141.25 | $199.53 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $363.08 | Professional | None | $162.18 | $162.18 | $363.08 |
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 $91.20 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $91.20 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $36.31 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $141.25 Typical High $165.96 | Professional | 54 · Surgery only | $138.04 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $27.54 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.20 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $131.83 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $128.82 | $131.83 | $154.88 |
Where Maryland sits
The same service costs 4.4 times more in Alaska than in Florida. 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
$200
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.