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 $114.82 Median $125.89 Typical High $173.78 | Professional | None | $114.82 | $125.89 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $354.81 | Facility | None | $50.12 | $50.12 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $338.84 | Professional | None | $112.20 | $158.49 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $257.04 | Professional | None | $154.88 | $181.97 | $257.04 |
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 $100.00 Median $151.36 Typical High $316.23 | Professional | None | $100.00 | $151.36 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $239.88 | Professional | None | $107.15 | $107.15 | $239.88 |
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 $57.54 Median $63.10 Typical High $87.10 | Professional | 52 · Reduced service | $57.54 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $22.91 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $87.10 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.05 Typical High $26.30 | Professional | 55 · Aftercare only | $17.38 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $89.13 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $81.28 | $89.13 | $123.03 |
Where Maryland sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 43rd of 51
$135
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.