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 $169.82 Median $281.84 Typical High $389.05 | Professional | None | $169.82 | $281.84 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $154.88 | Professional | None | $134.90 | $147.91 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $204.17 Typical High $338.84 | Facility | None | $50.12 | $204.17 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $380.19 | Professional | None | $162.18 | $257.04 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $549.54 | Professional | None | $275.42 | $331.13 | $549.54 |
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 $151.36 Median $239.88 Typical High $467.74 | Professional | None | $151.36 | $239.88 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $467.74 | Professional | None | $204.17 | $204.17 | $467.74 |
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 $85.11 Median $85.11 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $85.11 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $60.26 | Professional | 53 · Discontinued | $33.88 | $34.67 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $128.82 Typical High $223.87 | Professional | 54 · Surgery only | $125.89 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $44.67 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $120.23 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $117.49 | $120.23 | $208.93 |
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· 50th of 51
$204
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.