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 $147.91 Median $173.78 Typical High $190.55 | Professional | None | $147.91 | $173.78 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | None | $165.96 | $181.97 | $181.97 |
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 $144.54 Median $169.82 Typical High $302.00 | Professional | None | $144.54 | $169.82 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $354.81 | Professional | None | $208.93 | $234.42 | $354.81 |
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 $114.82 Median $158.49 Typical High $371.54 | Professional | None | $114.82 | $158.49 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $323.59 | Professional | None | $158.49 | $158.49 | $323.59 |
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 $74.13 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $74.13 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $29.51 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $112.20 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.79 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $112.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $104.71 | $112.20 | $134.90 |
Where Maryland sits
The same service costs 4.6 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· 44th of 51
$166
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.