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 $128.82 Median $177.83 Typical High $229.09 | Professional | None | $128.82 | $177.83 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $144.54 | Professional | None | $125.89 | $138.04 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $426.58 | Facility | None | $50.12 | $50.12 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $371.54 | Professional | None | $120.23 | $204.17 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $363.08 | Professional | None | $199.53 | $257.04 | $363.08 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $407.38 | Professional | None | $112.20 | $218.78 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $346.74 | Professional | None | $147.91 | $147.91 | $346.74 |
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 $64.57 Median $77.62 Typical High $114.82 | Professional | 52 · Reduced service | $64.57 | $77.62 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $25.70 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $117.49 Typical High $173.78 | Professional | 54 · Surgery only | $95.50 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.44 Typical High $34.67 | Professional | 55 · Aftercare only | $19.05 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.88 | $15.49 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $109.65 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $89.13 | $109.65 | $162.18 |
Where Maryland sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 36th of 51
$200
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.