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 $275.42 Median $398.11 Typical High $467.74 | Professional | None | $275.42 | $398.11 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | None | $257.04 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $446.68 Typical High $741.31 | Facility | None | $363.08 | $446.68 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $676.08 | Professional | None | $263.03 | $398.11 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $1,000.00 | Professional | None | $446.68 | $549.54 | $1,000.00 |
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 $245.47 Median $426.58 Typical High $831.76 | Professional | None | $245.47 | $426.58 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $776.25 | Professional | None | $407.38 | $407.38 | $776.25 |
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 $138.04 Median $138.04 Typical High $234.42 | Professional | 52 · Reduced service | $138.04 | $138.04 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $95.50 | Professional | 53 · Discontinued | $54.95 | $56.23 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $354.81 | Professional | 54 · Surgery only | $208.93 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $70.79 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $46.77 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $331.13 |
Where Maryland sits
The same service costs 3.3 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· 45th of 51
$389
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.