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 $323.59 Median $338.84 Typical High $371.54 | Professional | None | $323.59 | $338.84 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | None | $346.74 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $234.42 | Facility | None | $50.12 | $138.04 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $616.60 | Professional | None | $281.84 | $338.84 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $676.08 | Professional | None | $426.58 | $489.78 | $676.08 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $691.83 | Professional | None | $223.87 | $302.00 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $676.08 | Professional | None | $281.84 | $281.84 | $676.08 |
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 $162.18 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $162.18 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $64.57 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $239.88 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $257.04 |
Where Maryland sits
The same service costs 5.0 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· 38th of 51
$339
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.