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 $190.55 Median $281.84 Typical High $371.54 | Professional | None | $190.55 | $281.84 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | None | $194.98 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $257.04 Typical High $588.84 | Facility | None | $162.18 | $257.04 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $416.87 | Professional | None | $181.97 | $257.04 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $588.84 | Professional | None | $269.15 | $323.59 | $588.84 |
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 $162.18 Median $251.19 Typical High $512.86 | Professional | None | $162.18 | $251.19 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $457.09 | Professional | None | $223.87 | $223.87 | $457.09 |
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 $95.50 Median $97.72 Typical High $144.54 | Professional | 52 · Reduced service | $95.50 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.90 Typical High $57.54 | Professional | 53 · Discontinued | $38.02 | $38.90 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $218.78 | Professional | 54 · Surgery only | $144.54 | $144.54 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $28.84 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.50 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.05 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $204.17 |
Where Maryland sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 46th of 51
$240
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.