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 $169.82 Median $229.09 Typical High $275.42 | Professional | None | $169.82 | $229.09 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $213.80 | Professional | None | $186.21 | $208.93 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $190.55 Typical High $331.13 | Facility | None | $50.12 | $190.55 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $407.38 | Professional | None | $181.97 | $275.42 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $588.84 | Professional | None | $281.84 | $346.74 | $588.84 |
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 $169.82 Median $263.03 Typical High $512.86 | Professional | None | $169.82 | $263.03 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $489.78 | Professional | None | $218.78 | $218.78 | $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 $85.11 Median $95.50 Typical High $138.04 | Professional | 52 · Reduced service | $85.11 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.02 Typical High $54.95 | Professional | 53 · Discontinued | $33.88 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $141.25 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.05 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.98 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $131.83 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $117.49 | $131.83 | $190.55 |
Where Maryland sits
The same service costs 3.5 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.