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 $263.03 Median $288.40 Typical High $316.23 | Professional | None | $263.03 | $288.40 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | None | $245.47 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $151.36 Typical High $257.04 | Facility | None | $50.12 | $151.36 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $467.74 | Professional | None | $223.87 | $263.03 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $524.81 | Professional | None | $275.42 | $316.23 | $524.81 |
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 $204.17 Median $263.03 Typical High $602.56 | Professional | None | $204.17 | $263.03 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $426.58 | Professional | None | $269.15 | $269.15 | $426.58 |
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 $138.04 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $52.48 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $208.93 Typical High $234.42 | Professional | 54 · Surgery only | $194.98 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $38.90 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $27.54 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $194.98 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $181.97 | $194.98 | $218.78 |
Where Maryland sits
The same service costs 5.5 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· 43rd of 51
$269
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.