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 $186.21 Median $213.80 Typical High $263.03 | Professional | None | $186.21 | $213.80 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | None | $181.97 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $501.19 Typical High $891.25 | Facility | None | $426.58 | $501.19 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $398.11 | Professional | None | $173.78 | $229.09 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $478.63 | Professional | None | $288.40 | $331.13 | $478.63 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $478.63 | Professional | None | $147.91 | $208.93 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $446.68 | Professional | None | $223.87 | $223.87 | $446.68 |
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 $93.33 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $93.33 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $42.66 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $141.25 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $28.18 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.62 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $151.36 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $131.83 | $151.36 | $186.21 |
Where Maryland sits
The same service costs 4.3 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· 50th of 51
$214
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.