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 $229.09 Median $257.04 Typical High $275.42 | Professional | None | $229.09 | $257.04 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | None | $245.47 | $275.42 | $275.42 |
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 $218.78 Median $257.04 Typical High $446.68 | Professional | None | $218.78 | $257.04 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $501.19 | Professional | None | $288.40 | $331.13 | $501.19 |
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 $186.21 Median $239.88 Typical High $549.54 | Professional | None | $186.21 | $239.88 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $457.09 | Professional | None | $245.47 | $245.47 | $457.09 |
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 $114.82 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $114.82 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $45.71 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $169.82 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $158.49 | $169.82 | $194.98 |
Where Maryland sits
The same service costs 5.1 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· 44th of 51
$245
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.