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 $165.96 Median $251.19 Typical High $346.74 | Professional | None | $165.96 | $251.19 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | None | $169.82 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $588.84 | Facility | None | $154.88 | $239.88 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $371.54 | Professional | None | $158.49 | $229.09 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $524.81 | Professional | None | $239.88 | $295.12 | $524.81 |
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 $144.54 Median $223.87 Typical High $457.09 | Professional | None | $144.54 | $223.87 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $407.38 | Professional | None | $204.17 | $204.17 | $407.38 |
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 $83.18 Median $85.11 Typical High $131.83 | Professional | 52 · Reduced service | $83.18 | $85.11 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $52.48 | Professional | 53 · Discontinued | $33.11 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $128.82 Typical High $199.53 | Professional | 54 · Surgery only | $125.89 | $128.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $39.81 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $120.23 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $117.49 | $120.23 | $186.21 |
Where Maryland sits
The same service costs 3.4 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· 46th of 51
$219
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.