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 $154.88 Median $218.78 Typical High $288.40 | Professional | None | $154.88 | $218.78 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $181.97 | Professional | None | $138.04 | $154.88 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $295.12 Typical High $588.84 | Facility | None | $186.21 | $295.12 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $323.59 | Professional | None | $134.90 | $234.42 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $426.58 | Professional | None | $213.80 | $309.03 | $426.58 |
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 $114.82 Median $190.55 Typical High $354.81 | Professional | None | $114.82 | $190.55 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $363.08 | Professional | None | $194.98 | $194.98 | $363.08 |
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 $77.62 Median $97.72 Typical High $144.54 | Professional | 52 · Reduced service | $77.62 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.90 Typical High $58.88 | Professional | 53 · Discontinued | $30.90 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $218.78 | Professional | 54 · Surgery only | $117.49 | $147.91 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.50 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.49 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $138.04 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $109.65 | $138.04 | $204.17 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$174
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.