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 $181.97 Median $269.15 Typical High $398.11 | Professional | None | $181.97 | $269.15 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | None | $173.78 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,258.93 Typical High $2,187.76 | Facility | None | $446.68 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $363.08 | Professional | None | $177.83 | $251.19 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $512.86 | Professional | None | $281.84 | $338.84 | $512.86 |
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 $154.88 Median $229.09 Typical High $478.63 | Professional | None | $154.88 | $229.09 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $478.63 | Professional | None | $194.98 | $194.98 | $478.63 |
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 $91.20 Typical High $138.04 | Professional | 52 · Reduced service | $89.13 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $54.95 | Professional | 53 · Discontinued | $36.31 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $138.04 Typical High $208.93 | Professional | 54 · Surgery only | $134.90 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $27.54 Typical High $41.69 | Professional | 55 · Aftercare only | $26.92 | $27.54 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $128.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $125.89 | $128.82 | $194.98 |
Where Maryland sits
The same service costs 4.4 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· 34th of 51
$263
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.