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 $239.88 Median $363.08 Typical High $478.63 | Professional | None | $239.88 | $363.08 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $229.09 | Professional | None | $204.17 | $223.87 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $602.56 | Facility | None | $208.93 | $331.13 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $549.54 | Professional | None | $234.42 | $363.08 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $812.83 | Professional | None | $371.54 | $446.68 | $812.83 |
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 $218.78 Median $346.74 Typical High $660.69 | Professional | None | $218.78 | $346.74 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $630.96 | Professional | None | $309.03 | $309.03 | $630.96 |
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 $120.23 Median $120.23 Typical High $204.17 | Professional | 52 · Reduced service | $120.23 | $120.23 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $81.28 | Professional | 53 · Discontinued | $47.86 | $47.86 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $302.00 | Professional | 54 · Surgery only | $177.83 | $181.97 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $60.26 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $40.74 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $281.84 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 51st of 51
$282
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.