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 $302.00 Median $346.74 Typical High $446.68 | Professional | None | $302.00 | $346.74 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | None | $295.12 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,513.56 Typical High $2,398.83 | Facility | None | $446.68 | $1,513.56 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $645.65 | Professional | None | $288.40 | $398.11 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $776.25 | Professional | None | $446.68 | $512.86 | $776.25 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $794.33 | Professional | None | $229.09 | $346.74 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $707.95 | Professional | None | $363.08 | $363.08 | $707.95 |
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 $151.36 Median $173.78 Typical High $223.87 | Professional | 52 · Reduced service | $151.36 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $257.04 Typical High $338.84 | Professional | 54 · Surgery only | $223.87 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $44.67 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $239.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $208.93 | $239.88 | $316.23 |
Where Maryland sits
The same service costs 5.1 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· 41st of 51
$363
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.