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 $234.42 Median $288.40 Typical High $346.74 | Professional | None | $234.42 | $288.40 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | None | $229.09 | $251.19 | $251.19 |
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 $223.87 Median $309.03 Typical High $489.78 | Professional | None | $223.87 | $309.03 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $691.83 | Professional | None | $323.59 | $407.38 | $691.83 |
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 $199.53 Median $302.00 Typical High $630.96 | Professional | None | $199.53 | $302.00 | $630.96 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $562.34 | Professional | None | $269.15 | $269.15 | $562.34 |
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 $117.49 Median $120.23 Typical High $173.78 | Professional | 52 · Reduced service | $117.49 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $69.18 | Professional | 53 · Discontinued | $46.77 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $263.03 | Professional | 54 · Surgery only | $177.83 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $245.47 |
Where Maryland sits
The same service costs 4.0 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· 37th of 51
$324
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.