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 $131.83 Median $169.82 Typical High $234.42 | Professional | None | $131.83 | $169.82 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | None | $104.71 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,258.93 Typical High $2,041.74 | Facility | None | $331.13 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $194.98 | Professional | None | $100.00 | $151.36 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $281.84 | Professional | None | $177.83 | $204.17 | $281.84 |
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 $83.18 Median $128.82 Typical High $245.47 | Professional | None | $83.18 | $128.82 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $295.12 | Professional | None | $131.83 | $131.83 | $295.12 |
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 $66.07 Median $74.13 Typical High $117.49 | Professional | 52 · Reduced service | $66.07 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $29.51 Typical High $46.77 | Professional | 53 · Discontinued | $26.92 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $109.65 Typical High $173.78 | Professional | 54 · Surgery only | $100.00 | $109.65 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $35.48 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.79 Typical High $23.44 | Professional | 56 · Pre-op care only | $13.18 | $14.79 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $102.33 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $93.33 | $102.33 | $162.18 |
Where Maryland sits
The same service costs 4.8 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· 49th of 51
$141
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.