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 $93.33 Median $131.83 Typical High $144.54 | Professional | None | $93.33 | $131.83 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $128.82 | Professional | None | $109.65 | $123.03 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $134.90 Typical High $676.08 | Facility | None | $85.11 | $134.90 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $346.74 | Professional | None | $104.71 | $162.18 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $295.12 | Professional | None | $173.78 | $204.17 | $295.12 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $309.03 | Professional | None | $107.15 | $173.78 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $269.15 | Professional | None | $131.83 | $131.83 | $269.15 |
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 $46.77 Median $66.07 Typical High $72.44 | Professional | 52 · Reduced service | $46.77 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $28.84 | Professional | 53 · Discontinued | $18.62 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $70.79 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $14.13 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $93.33 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $66.07 | $93.33 | $100.00 |
Where Maryland sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 46th 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.