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 $120.23 Median $165.96 Typical High $208.93 | Professional | None | $120.23 | $165.96 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | None | $123.03 | $138.04 | $138.04 |
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 $114.82 Median $177.83 Typical High $281.84 | Professional | None | $114.82 | $177.83 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $398.11 | Professional | None | $181.97 | $223.87 | $398.11 |
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 $109.65 Median $169.82 Typical High $331.13 | Professional | None | $109.65 | $169.82 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $309.03 | Professional | None | $151.36 | $151.36 | $309.03 |
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 $60.26 Median $61.66 Typical High $100.00 | Professional | 52 · Reduced service | $60.26 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $39.81 | Professional | 53 · Discontinued | $23.99 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $151.36 | Professional | 54 · Surgery only | $91.20 | $91.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $30.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $141.25 |
Where Maryland sits
The same service costs 3.3 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
$148
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.