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 $165.96 Typical High $251.19 | Professional | None | $114.82 | $165.96 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | None | $134.90 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $724.44 | Facility | None | $117.49 | $190.55 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $426.58 | Professional | None | $125.89 | $181.97 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $338.84 | Professional | None | $194.98 | $229.09 | $338.84 |
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 $112.20 Median $186.21 Typical High $354.81 | Professional | None | $112.20 | $186.21 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $309.03 | Professional | None | $128.82 | $128.82 | $309.03 |
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 $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $57.54 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.92 Typical High $33.88 | Professional | 53 · Discontinued | $22.91 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $100.00 Typical High $125.89 | Professional | 54 · Surgery only | $85.11 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.48 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $93.33 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $79.43 | $93.33 | $117.49 |
Where Maryland sits
The same service costs 3.9 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· 41st of 51
$170
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.