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 $162.18 Median $162.18 Typical High $169.82 | Professional | None | $162.18 | $162.18 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | None | $125.89 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $1,949.84 | Facility | None | $446.68 | $1,096.48 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $208.93 | Professional | None | $123.03 | $134.90 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $194.98 | Professional | None | $123.03 | $134.90 | $194.98 |
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 $123.03 Median $158.49 Typical High $269.15 | Professional | None | $123.03 | $158.49 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $190.55 | Professional | None | $123.03 | $123.03 | $190.55 |
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 $81.28 Median $81.28 Typical High $85.11 | Professional | 52 · Reduced service | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 54 · Surgery only | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $120.23 |
Where Maryland sits
The same service costs 9.8 times more in Nebraska than in Utah. 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· 47th of 51
$162
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.