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 $173.78 Median $173.78 Typical High $181.97 | Professional | None | $173.78 | $173.78 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $2,691.53 | Facility | None | $512.86 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $323.59 | Professional | None | $154.88 | $177.83 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $302.00 | Professional | None | $173.78 | $199.53 | $302.00 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $407.38 | Professional | None | $147.91 | $186.21 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $263.03 | Professional | None | $173.78 | $173.78 | $263.03 |
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 $87.10 Median $87.10 Typical High $91.20 | Professional | 52 · Reduced service | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $131.83 Typical High $138.04 | Professional | 54 · Surgery only | $128.82 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.30 Typical High $27.54 | Professional | 55 · Aftercare only | $25.70 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $18.20 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $123.03 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $120.23 | $123.03 | $128.82 |
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· 46th of 51
$182
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.