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 $144.54 Median $186.21 Typical High $234.42 | Professional | None | $144.54 | $186.21 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | None | $154.88 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $588.84 | Facility | None | $151.36 | $234.42 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $331.13 | Professional | None | $138.04 | $190.55 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $416.87 | Professional | None | $245.47 | $275.42 | $416.87 |
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 $114.82 Median $173.78 Typical High $389.05 | Professional | None | $114.82 | $173.78 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $380.19 | Professional | None | $177.83 | $177.83 | $380.19 |
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 $72.44 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $72.44 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $128.82 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.98 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.45 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $120.23 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $120.23 | $162.18 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 50th of 51
$178
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.