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 $87.10 Median $109.65 Typical High $131.83 | Professional | None | $87.10 | $109.65 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | None | $87.10 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $85.11 Typical High $144.54 | Facility | None | $50.12 | $85.11 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $204.17 | Professional | None | $83.18 | $109.65 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $223.87 | Professional | None | $134.90 | $154.88 | $223.87 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $229.09 | Professional | None | $74.13 | $104.71 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $213.80 | Professional | None | $109.65 | $109.65 | $213.80 |
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 $43.65 Median $47.86 Typical High $66.07 | Professional | 52 · Reduced service | $43.65 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.05 Typical High $26.30 | Professional | 53 · Discontinued | $17.38 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $72.44 Typical High $97.72 | Professional | 54 · Surgery only | $66.07 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.45 Typical High $19.95 | Professional | 55 · Aftercare only | $13.18 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $67.61 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $61.66 | $67.61 | $91.20 |
Where Maryland sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 50th of 51
$102
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.