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 $181.97 Median $245.47 Typical High $389.05 | Facility | None | $181.97 | $245.47 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $288.40 | Professional | None | $147.91 | $194.98 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | None | $144.54 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $190.55 Typical High $588.84 | Facility | None | $120.23 | $190.55 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $275.42 | Professional | None | $141.25 | $181.97 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $389.05 | Professional | None | $204.17 | $234.42 | $389.05 |
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 $123.03 Median $177.83 Typical High $380.19 | Professional | None | $123.03 | $177.83 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $323.59 | Professional | None | $147.91 | $147.91 | $323.59 |
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 $72.44 Median $75.86 Typical High $100.00 | Professional | 52 · Reduced service | $72.44 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.20 Typical High $40.74 | Professional | 53 · Discontinued | $29.51 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $109.65 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $104.71 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $102.33 | $104.71 | $141.25 |
Where Maryland sits
The same service costs 3.9 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· 41st of 51
$178
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.