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 $147.91 Typical High $177.83 | Professional | None | $125.89 | $147.91 | $177.83 |
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 $93.33 Median $147.91 Typical High $588.84 | Facility | None | $93.33 | $147.91 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $208.93 | Professional | None | $109.65 | $144.54 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $239.88 | Professional | None | $134.90 | $169.82 | $239.88 |
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 $131.83 Typical High $245.47 | Professional | None | $95.50 | $131.83 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $204.17 | Professional | None | $123.03 | $123.03 | $204.17 |
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 $63.10 Median $67.61 Typical High $89.13 | Professional | 52 · Reduced service | $63.10 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $25.12 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $134.90 | Professional | 54 · Surgery only | $93.33 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $95.50 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $87.10 | $95.50 | $125.89 |
Where Maryland sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 46th of 51
$129
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.