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 Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $229.09 | Facility | None | $120.23 | $125.89 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $245.47 | Professional | None | $95.50 | $162.18 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | None | $114.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $162.18 Typical High $588.84 | Facility | None | $104.71 | $162.18 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $354.81 | Professional | None | $102.33 | $173.78 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $323.59 | Professional | None | $194.98 | $223.87 | $323.59 |
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 $97.72 Median $169.82 Typical High $316.23 | Professional | None | $97.72 | $169.82 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $302.00 | Professional | None | $123.03 | $123.03 | $302.00 |
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 $47.86 Median $61.66 Typical High $81.28 | Professional | 52 · Reduced service | $47.86 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $32.36 | Professional | 53 · Discontinued | $19.05 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $70.79 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $14.13 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $16.22 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $85.11 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $66.07 | $85.11 | $114.82 |
Where Maryland sits
The same service costs 3.6 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· 48th of 51
$148
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.