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 $154.88 Median $218.78 Typical High $275.42 | Professional | None | $154.88 | $218.78 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | None | $154.88 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $436.52 | Facility | None | $173.78 | $281.84 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $389.05 | Professional | None | $147.91 | $239.88 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $489.78 | Professional | None | $281.84 | $316.23 | $489.78 |
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 $125.89 Median $213.80 Typical High $446.68 | Professional | None | $125.89 | $213.80 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $436.52 | Professional | None | $234.42 | $234.42 | $436.52 |
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 $75.86 Median $107.15 Typical High $138.04 | Professional | 52 · Reduced service | $75.86 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $42.66 Typical High $54.95 | Professional | 53 · Discontinued | $30.90 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $208.93 | Professional | 54 · Surgery only | $114.82 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $41.69 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.49 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $147.91 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $107.15 | $147.91 | $194.98 |
Where Maryland sits
The same service costs 4.4 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
$209
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.