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 $83.18 Median $83.18 Typical High $128.82 | Professional | None | $83.18 | $83.18 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | None | $75.86 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,023.29 Typical High $1,659.59 | Facility | None | $331.13 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $239.88 | Professional | None | $79.43 | $95.50 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $154.88 | Professional | None | $74.13 | $87.10 | $154.88 |
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 $69.18 Median $107.15 Typical High $190.55 | Professional | None | $69.18 | $107.15 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $114.82 | Professional | None | $63.10 | $63.10 | $114.82 |
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 $40.74 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $40.74 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.60 Typical High $16.98 | Professional | 53 · Discontinued | $16.22 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | 54 · Surgery only | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.30 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.13 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | 78 · Unplanned return to OR | $57.54 | $57.54 | $58.88 |
Where Maryland sits
The same service costs 8.5 times more in Nebraska than in New York. 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· 38th of 51
$107
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.