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 $93.33 Median $109.65 Typical High $131.83 | Professional | None | $93.33 | $109.65 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | None | $100.00 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $173.78 | Facility | None | $50.12 | $102.33 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $194.98 | Professional | None | $83.18 | $112.20 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $245.47 | Professional | None | $158.49 | $181.97 | $245.47 |
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 $69.18 Median $100.00 Typical High $239.88 | Professional | None | $69.18 | $100.00 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $245.47 | Professional | None | $100.00 | $100.00 | $245.47 |
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 $46.77 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $46.77 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $26.92 | Professional | 53 · Discontinued | $18.62 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $75.86 Typical High $100.00 | Professional | 54 · Surgery only | $69.18 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $70.79 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $64.57 | $70.79 | $93.33 |
Where Maryland sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 47th of 51
$110
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.