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 $151.36 Median $190.55 Typical High $245.47 | Professional | None | $151.36 | $190.55 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | None | $154.88 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $588.84 | Facility | None | $138.04 | $213.80 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $338.84 | Professional | None | $144.54 | $213.80 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $478.63 | Professional | None | $223.87 | $275.42 | $478.63 |
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 $134.90 Median $208.93 Typical High $416.87 | Professional | None | $134.90 | $208.93 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $380.19 | Professional | None | $186.21 | $186.21 | $380.19 |
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 $75.86 Median $77.62 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $77.62 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $48.98 | Professional | 53 · Discontinued | $30.20 | $30.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $114.82 Typical High $181.97 | Professional | 54 · Surgery only | $112.20 | $114.82 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $107.15 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $104.71 | $107.15 | $169.82 |
Where Maryland sits
The same service costs 3.5 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
$182
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.