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 $91.20 Median $97.72 Typical High $128.82 | Professional | None | $91.20 | $97.72 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | None | $93.33 | $104.71 | $104.71 |
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 $89.13 Median $117.49 Typical High $186.21 | Professional | None | $89.13 | $117.49 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $257.04 | Professional | None | $123.03 | $144.54 | $257.04 |
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 $81.28 Median $117.49 Typical High $239.88 | Professional | None | $81.28 | $117.49 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $199.53 | Professional | None | $102.33 | $102.33 | $199.53 |
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 $45.71 Median $46.77 Typical High $64.57 | Professional | 52 · Reduced service | $45.71 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | 53 · Discontinued | $18.62 | $18.62 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $70.79 Typical High $95.50 | Professional | 54 · Surgery only | $69.18 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $19.05 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $66.07 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $64.57 | $66.07 | $89.13 |
Where Maryland sits
The same service costs 3.8 times more in Alaska than in New York. 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· 47th of 51
$105
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.