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 $138.04 Median $223.87 Typical High $275.42 | Professional | None | $138.04 | $223.87 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | None | $128.82 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $354.81 | Facility | None | $50.12 | $50.12 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $407.38 | Professional | None | $123.03 | $218.78 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $380.19 | Professional | None | $194.98 | $263.03 | $380.19 |
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 $109.65 Median $213.80 Typical High $389.05 | Professional | None | $109.65 | $213.80 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $354.81 | Professional | None | $162.18 | $162.18 | $354.81 |
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 $69.18 Median $83.18 Typical High $131.83 | Professional | 52 · Reduced service | $69.18 | $83.18 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $33.11 Typical High $53.70 | Professional | 53 · Discontinued | $27.54 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $125.89 Typical High $199.53 | Professional | 54 · Surgery only | $102.33 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.12 Typical High $39.81 | Professional | 55 · Aftercare only | $20.42 | $25.12 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.60 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.80 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $117.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $95.50 | $117.49 | $186.21 |
Where Maryland sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$174
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.