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 $177.83 Median $190.55 Typical High $204.17 | Professional | None | $177.83 | $190.55 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | None | $147.91 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $138.04 Typical High $588.84 | Facility | None | $87.10 | $138.04 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $190.55 | Professional | None | $134.90 | $144.54 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $269.15 | Professional | None | $158.49 | $186.21 | $269.15 |
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 $109.65 Median $141.25 Typical High $295.12 | Professional | None | $109.65 | $141.25 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $263.03 | Professional | None | $123.03 | $123.03 | $263.03 |
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 $89.13 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $40.74 | Professional | 53 · Discontinued | $35.48 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $141.25 Typical High $151.36 | Professional | 54 · Surgery only | $134.90 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $30.20 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $131.83 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $125.89 | $131.83 | $141.25 |
Where Maryland sits
The same service costs 4.6 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· 41st of 51
$166
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.