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 $69.18 Median $91.20 Typical High $104.71 | Professional | None | $69.18 | $91.20 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | None | $72.44 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $354.81 | Facility | None | $50.12 | $50.12 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $138.04 | Professional | None | $67.61 | $91.20 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $194.98 | Professional | None | $93.33 | $114.82 | $194.98 |
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 $57.54 Median $87.10 Typical High $181.97 | Professional | None | $57.54 | $87.10 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $158.49 | Professional | None | $75.86 | $75.86 | $158.49 |
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 $34.67 Median $35.48 Typical High $52.48 | Professional | 52 · Reduced service | $34.67 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $20.89 | Professional | 53 · Discontinued | $14.13 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $53.70 Typical High $77.62 | Professional | 54 · Surgery only | $52.48 | $53.70 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $15.49 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $50.12 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $48.98 | $50.12 | $72.44 |
Where Maryland sits
The same service costs 3.8 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
$81.28
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.