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 $117.49 Median $134.90 Typical High $147.91 | Professional | None | $117.49 | $134.90 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | None | $123.03 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $588.84 | Facility | None | $81.28 | $128.82 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $239.88 | Professional | None | $107.15 | $131.83 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $275.42 | Professional | None | $147.91 | $169.82 | $275.42 |
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 $104.71 Median $134.90 Typical High $275.42 | Professional | None | $104.71 | $134.90 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $234.42 | Professional | None | $144.54 | $144.54 | $234.42 |
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 $58.88 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $58.88 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $23.44 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $87.10 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.75 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $87.10 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $81.28 | $87.10 | $100.00 |
Where Maryland sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 45th 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.