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 $162.18 Median $162.18 Typical High $169.82 | Professional | None | $162.18 | $162.18 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | None | $162.18 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,659.59 Typical High $2,691.53 | Facility | None | $331.13 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $295.12 | Professional | None | $144.54 | $165.96 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $295.12 | Professional | None | $162.18 | $186.21 | $295.12 |
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 $138.04 Median $165.96 Typical High $363.08 | Professional | None | $138.04 | $165.96 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | None | $162.18 | $162.18 | $251.19 |
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 $81.28 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 54 · Surgery only | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $120.23 |
Where Maryland sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 46th of 51
$170
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.