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 $281.84 Median $323.59 Typical High $346.74 | Professional | None | $281.84 | $323.59 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | None | $288.40 | $323.59 | $323.59 |
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 $257.04 Median $309.03 Typical High $549.54 | Professional | None | $257.04 | $309.03 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $645.65 | Professional | None | $407.38 | $457.09 | $645.65 |
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 $204.17 Median $288.40 Typical High $660.69 | Professional | None | $204.17 | $288.40 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $630.96 | Professional | None | $281.84 | $281.84 | $630.96 |
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 $141.25 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $56.23 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $245.47 |
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· 45th of 51
$295
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.