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 $208.93 Median $295.12 Typical High $371.54 | Professional | None | $208.93 | $295.12 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | None | $199.53 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $190.55 Typical High $346.74 | Facility | None | $50.12 | $190.55 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $436.52 | Professional | None | $199.53 | $275.42 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $616.60 | Professional | None | $281.84 | $354.81 | $616.60 |
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 $177.83 Median $263.03 Typical High $549.54 | Professional | None | $177.83 | $263.03 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $489.78 | Professional | None | $239.88 | $239.88 | $489.78 |
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 $104.71 Median $104.71 Typical High $154.88 | Professional | 52 · Reduced service | $104.71 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $61.66 | Professional | 53 · Discontinued | $41.69 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $144.54 | $147.91 | $213.80 |
Where Maryland sits
The same service costs 3.9 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· 47th of 51
$245
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.