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 $190.55 Median $213.80 Typical High $239.88 | Professional | None | $190.55 | $213.80 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | None | $208.93 | $234.42 | $234.42 |
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 $181.97 Median $208.93 Typical High $380.19 | Professional | None | $181.97 | $208.93 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $426.58 | Professional | None | $245.47 | $281.84 | $426.58 |
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 $144.54 Median $194.98 Typical High $457.09 | Professional | None | $144.54 | $194.98 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $380.19 | Professional | None | $194.98 | $194.98 | $380.19 |
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 $95.50 Median $102.33 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $144.54 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $33.88 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $144.54 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $134.90 | $144.54 | $158.49 |
Where Maryland sits
The same service costs 4.8 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· 42nd of 51
$209
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.