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 $123.03 Median $151.36 Typical High $213.80 | Professional | None | $123.03 | $151.36 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $144.54 | Professional | None | $107.15 | $120.23 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $128.82 Typical High $218.78 | Facility | None | $50.12 | $128.82 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $229.09 | Professional | None | $109.65 | $162.18 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $295.12 | Professional | None | $154.88 | $208.93 | $295.12 |
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 $91.20 Median $141.25 Typical High $269.15 | Professional | None | $91.20 | $141.25 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $251.19 | Professional | None | $89.13 | $89.13 | $251.19 |
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 $72.44 Typical High $107.15 | Professional | 52 · Reduced service | $61.66 | $72.44 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.84 Typical High $43.65 | Professional | 53 · Discontinued | $24.55 | $28.84 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $107.15 Typical High $162.18 | Professional | 54 · Surgery only | $93.33 | $107.15 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.38 Typical High $32.36 | Professional | 55 · Aftercare only | $18.62 | $21.38 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.45 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.30 | $14.45 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $100.00 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $87.10 | $100.00 | $151.36 |
Where Maryland sits
The same service costs 3.5 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· 49th 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.