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 $125.89 Median $177.83 Typical High $229.09 | Professional | None | $125.89 | $177.83 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $147.91 | Professional | None | $109.65 | $123.03 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $602.56 | Facility | None | $128.82 | $208.93 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $245.47 | Professional | None | $112.20 | $169.82 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $302.00 | Professional | None | $158.49 | $218.78 | $302.00 |
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 $95.50 Median $147.91 Typical High $269.15 | Professional | None | $95.50 | $147.91 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $257.04 | Professional | None | $138.04 | $138.04 | $257.04 |
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 $61.66 Median $75.86 Typical High $114.82 | Professional | 52 · Reduced service | $61.66 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $25.12 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $87.10 | $107.15 | $162.18 |
Where Maryland sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 48th of 51
$138
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.