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 $107.15 Median $144.54 Typical High $194.98 | Professional | None | $107.15 | $144.54 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | None | $104.71 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $154.88 Typical High $588.84 | Facility | None | $97.72 | $154.88 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $194.98 | Professional | None | $102.33 | $134.90 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $288.40 | Professional | None | $151.36 | $169.82 | $288.40 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $269.15 | Professional | None | $85.11 | $125.89 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $234.42 | Professional | None | $107.15 | $107.15 | $234.42 |
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 $54.95 Typical High $75.86 | Professional | 52 · Reduced service | $52.48 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $30.20 | Professional | 53 · Discontinued | $21.38 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $83.18 Typical High $112.20 | Professional | 54 · Surgery only | $79.43 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $22.91 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $77.62 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $74.13 | $77.62 | $104.71 |
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· 39th of 51
$132
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.