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 $120.23 Median $128.82 Typical High $158.49 | Professional | None | $120.23 | $128.82 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | None | $134.90 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $151.36 | Facility | None | $50.12 | $91.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $239.88 | Professional | None | $109.65 | $125.89 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $239.88 | Professional | None | $138.04 | $158.49 | $239.88 |
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 $89.13 Median $114.82 Typical High $257.04 | Professional | None | $89.13 | $114.82 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $218.78 | Professional | None | $107.15 | $107.15 | $218.78 |
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 $60.26 Median $60.26 Typical High $64.57 | Professional | 52 · Reduced service | $60.26 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $26.30 | Professional | 53 · Discontinued | $23.99 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 54 · Surgery only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $91.20 |
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· 37th of 51
$129
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.