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 $85.11 Median $109.65 Typical High $147.91 | Professional | None | $85.11 | $109.65 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | None | $89.13 | $97.72 | $97.72 |
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 $83.18 Median $128.82 Typical High $199.53 | Professional | None | $83.18 | $128.82 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $288.40 | Professional | None | $134.90 | $162.18 | $288.40 |
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 $75.86 Median $123.03 Typical High $239.88 | Professional | None | $75.86 | $123.03 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $229.09 | Professional | None | $112.20 | $112.20 | $229.09 |
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 $42.66 Median $43.65 Typical High $72.44 | Professional | 52 · Reduced service | $42.66 | $43.65 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $29.51 | Professional | 53 · Discontinued | $16.98 | $17.38 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $66.07 Typical High $109.65 | Professional | 54 · Surgery only | $64.57 | $66.07 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $21.88 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $61.66 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $60.26 | $61.66 | $102.33 |
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· 48th of 51
$110
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.