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 $269.15 Median $302.00 Typical High $371.54 | Professional | None | $269.15 | $302.00 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | None | $288.40 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $234.42 | Facility | None | $50.12 | $138.04 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $512.86 | Professional | None | $234.42 | $281.84 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $588.84 | Professional | None | $354.81 | $398.11 | $588.84 |
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 $181.97 Median $251.19 Typical High $588.84 | Professional | None | $181.97 | $251.19 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $549.54 | Professional | None | $234.42 | $234.42 | $549.54 |
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 $131.83 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $64.57 | Professional | 53 · Discontinued | $53.70 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $199.53 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $186.21 | $199.53 | $223.87 |
Where Maryland sits
The same service costs 5.4 times more in Alaska than in Texas. 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· 37th of 51
$288
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.