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 $100.00 Median $114.82 Typical High $123.03 | Professional | None | $100.00 | $114.82 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $85.11 Typical High $147.91 | Facility | None | $50.12 | $85.11 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $204.17 | Professional | None | $97.72 | $114.82 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $223.87 | Professional | None | $131.83 | $147.91 | $223.87 |
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 $79.43 Median $104.71 Typical High $245.47 | Professional | None | $79.43 | $104.71 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $204.17 | Professional | None | $104.71 | $104.71 | $204.17 |
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 $50.12 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $50.12 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $19.95 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $75.86 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.00 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $75.86 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $70.79 | $75.86 | $87.10 |
Where Maryland sits
The same service costs 4.5 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· 40th of 51
$115
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.