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 $128.82 Median $162.18 Typical High $213.80 | Professional | None | $128.82 | $162.18 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | None | $131.83 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $134.90 Typical High $229.09 | Facility | None | $50.12 | $134.90 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $295.12 | Professional | None | $123.03 | $190.55 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $426.58 | Professional | None | $194.98 | $239.88 | $426.58 |
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 $117.49 Median $181.97 Typical High $354.81 | Professional | None | $117.49 | $181.97 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $331.13 | Professional | None | $162.18 | $162.18 | $331.13 |
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 $64.57 Median $64.57 Typical High $107.15 | Professional | 52 · Reduced service | $64.57 | $64.57 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $42.66 | Professional | 53 · Discontinued | $25.70 | $26.30 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $97.72 Typical High $162.18 | Professional | 54 · Surgery only | $95.50 | $97.72 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $32.36 | Professional | 55 · Aftercare only | $19.05 | $19.50 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $91.20 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $89.13 | $91.20 | $151.36 |
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
$151
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.