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 $309.03 Median $338.84 Typical High $549.54 | Facility | None | $309.03 | $338.84 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $537.03 | Professional | None | $245.47 | $398.11 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $239.88 | Professional | None | $208.93 | $229.09 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $794.33 | Facility | None | $380.19 | $501.19 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $562.34 | Professional | None | $239.88 | $371.54 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $831.76 | Professional | None | $380.19 | $457.09 | $831.76 |
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 $223.87 Median $354.81 Typical High $676.08 | Professional | None | $223.87 | $354.81 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $645.65 | Professional | None | $316.23 | $316.23 | $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 $123.03 Median $125.89 Typical High $208.93 | Professional | 52 · Reduced service | $123.03 | $125.89 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $83.18 | Professional | 53 · Discontinued | $48.98 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $309.03 | Professional | 54 · Surgery only | $181.97 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $63.10 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $41.69 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $173.78 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $169.82 | $173.78 | $288.40 |
Where Maryland sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$331
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.