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 Facility Modifier None Typical Low $223.87 Median $245.47 Typical High $323.59 | Facility | None | $223.87 | $245.47 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $323.59 | Professional | None | $177.83 | $239.88 | $323.59 |
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 $758.58 Typical High $1,348.96 | Facility | None | $446.68 | $758.58 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $338.84 | Professional | None | $173.78 | $229.09 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $478.63 | Professional | None | $257.04 | $288.40 | $478.63 |
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 $151.36 Median $218.78 Typical High $467.74 | Professional | None | $151.36 | $218.78 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $398.11 | Professional | None | $186.21 | $186.21 | $398.11 |
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 $123.03 | Professional | 52 · Reduced service | $89.13 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $36.31 Typical High $48.98 | Professional | 53 · Discontinued | $35.48 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $134.90 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $17.78 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $169.82 |
Where Maryland sits
The same service costs 4.7 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· 40th of 51
$234
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.