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 $173.78 Median $234.42 Typical High $295.12 | Professional | None | $173.78 | $234.42 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | None | $173.78 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $758.58 Typical High $1,348.96 | Facility | None | $331.13 | $758.58 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $416.87 | Professional | None | $169.82 | $257.04 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $512.86 | Professional | None | $288.40 | $331.13 | $512.86 |
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 $138.04 Median $229.09 Typical High $512.86 | Professional | None | $138.04 | $229.09 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $457.09 | Professional | None | $245.47 | $245.47 | $457.09 |
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 $87.10 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $34.67 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $128.82 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $34.67 Typical High $43.65 | Professional | 55 · Aftercare only | $26.30 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $162.18 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $120.23 | $162.18 | $204.17 |
Where Maryland sits
The same service costs 4.1 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· 45th of 51
$234
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.