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 $134.90 Median $208.93 Typical High $295.12 | Professional | None | $134.90 | $208.93 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $147.91 | Professional | None | $112.20 | $125.89 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $436.52 | Facility | None | $120.23 | $194.98 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $302.00 | Professional | None | $120.23 | $208.93 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $371.54 | Professional | None | $186.21 | $269.15 | $371.54 |
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 $102.33 Median $181.97 Typical High $316.23 | Professional | None | $102.33 | $181.97 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $316.23 | Professional | None | $186.21 | $186.21 | $316.23 |
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 $67.61 Median $97.72 Typical High $147.91 | Professional | 52 · Reduced service | $67.61 | $97.72 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $36.31 Typical High $58.88 | Professional | 53 · Discontinued | $26.92 | $36.31 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $134.90 Typical High $223.87 | Professional | 54 · Surgery only | $102.33 | $134.90 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.84 Typical High $44.67 | Professional | 55 · Aftercare only | $20.42 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.50 Typical High $29.51 | Professional | 56 · Pre-op care only | $13.49 | $19.50 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $125.89 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $95.50 | $125.89 | $208.93 |
Where Maryland sits
The same service costs 3.5 times more in Alaska 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· 49th of 51
$151
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.