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 $275.42 Typical High $354.81 | Professional | None | $208.93 | $275.42 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | None | $204.17 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $588.84 | Facility | None | $50.12 | $52.48 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $537.03 | Professional | None | $199.53 | $316.23 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $758.58 | Professional | None | $323.59 | $389.05 | $758.58 |
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 $208.93 Median $346.74 Typical High $676.08 | Professional | None | $208.93 | $346.74 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $549.54 | Professional | None | $346.74 | $346.74 | $549.54 |
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 $114.82 Typical High $177.83 | Professional | 52 · Reduced service | $104.71 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $41.69 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $173.78 Typical High $263.03 | Professional | 54 · Surgery only | $158.49 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $34.67 Typical High $53.70 | Professional | 55 · Aftercare only | $31.62 | $34.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.91 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.89 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $162.18 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $147.91 | $162.18 | $245.47 |
Where Maryland sits
The same service costs 4.1 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· 45th of 51
$302
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.