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 $257.04 Median $346.74 Typical High $398.11 | Professional | None | $257.04 | $346.74 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | None | $257.04 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $537.03 | Facility | None | $50.12 | $295.12 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $575.44 | Professional | None | $251.19 | $346.74 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $724.44 | Professional | None | $416.87 | $478.63 | $724.44 |
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 $204.17 Median $309.03 Typical High $676.08 | Professional | None | $204.17 | $309.03 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $660.69 | Professional | None | $316.23 | $316.23 | $660.69 |
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 $128.82 Median $147.91 Typical High $199.53 | Professional | 52 · Reduced service | $128.82 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $52.48 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $223.87 Typical High $302.00 | Professional | 54 · Surgery only | $194.98 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $44.67 Typical High $60.26 | Professional | 55 · Aftercare only | $38.90 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $29.51 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.70 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $208.93 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $181.97 | $208.93 | $281.84 |
Where Maryland sits
The same service costs 4.5 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
$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.