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 $104.71 Median $151.36 Typical High $218.78 | Professional | None | $104.71 | $151.36 | $218.78 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | None | $100.00 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $117.49 Typical High $199.53 | Facility | None | $50.12 | $117.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $223.87 | Professional | None | $102.33 | $144.54 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $316.23 | Professional | None | $162.18 | $181.97 | $316.23 |
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 $79.43 Median $134.90 Typical High $275.42 | Professional | None | $79.43 | $134.90 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $263.03 | Professional | None | $120.23 | $120.23 | $263.03 |
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 $52.48 Median $53.70 Typical High $79.43 | Professional | 52 · Reduced service | $52.48 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $31.62 | Professional | 53 · Discontinued | $20.89 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $81.28 Typical High $120.23 | Professional | 54 · Surgery only | $79.43 | $81.28 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $23.99 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $75.86 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $74.13 | $75.86 | $112.20 |
Where Maryland sits
The same service costs 4.1 times more in Alaska 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· 49th of 51
$120
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.