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 $218.78 Median $269.15 Typical High $338.84 | Professional | None | $218.78 | $269.15 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | None | $208.93 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $295.12 Typical High $602.56 | Facility | None | $177.83 | $295.12 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $616.60 | Professional | None | $204.17 | $309.03 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $524.81 | Professional | None | $309.03 | $354.81 | $524.81 |
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 $199.53 Median $354.81 Typical High $616.60 | Professional | None | $199.53 | $354.81 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $478.63 | Professional | None | $263.03 | $263.03 | $478.63 |
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 $109.65 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $44.67 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $257.04 | Professional | 54 · Surgery only | $165.96 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.02 Typical High $51.29 | Professional | 55 · Aftercare only | $33.11 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.70 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $177.83 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $154.88 | $177.83 | $239.88 |
Where Maryland sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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
$275
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.