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 $213.80 Median $229.09 Typical High $467.74 | Facility | None | $213.80 | $229.09 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $398.11 | Professional | None | $213.80 | $309.03 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | None | $169.82 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $446.68 Typical High $776.25 | Facility | None | $380.19 | $446.68 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $489.78 | Professional | None | $208.93 | $346.74 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $758.58 | Professional | None | $363.08 | $457.09 | $758.58 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $630.96 | Professional | None | $181.97 | $309.03 | $630.96 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $645.65 | Professional | None | $288.40 | $288.40 | $645.65 |
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 $107.15 Median $107.15 Typical High $199.53 | Professional | 52 · Reduced service | $107.15 | $107.15 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $79.43 | Professional | 53 · Discontinued | $42.66 | $42.66 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $162.18 Typical High $302.00 | Professional | 54 · Surgery only | $158.49 | $162.18 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $60.26 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $39.81 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $151.36 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $147.91 | $151.36 | $281.84 |
Where Maryland sits
The same service costs 3.4 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· 48th of 51
$288
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.