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 $309.03 Median $331.13 Typical High $380.19 | Professional | None | $309.03 | $331.13 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | None | $316.23 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $436.52 | Facility | None | $125.89 | $204.17 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $588.84 | Professional | None | $281.84 | $323.59 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $676.08 | Professional | None | $389.05 | $446.68 | $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 $218.78 Median $288.40 Typical High $691.83 | Professional | None | $218.78 | $288.40 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $616.60 | Professional | None | $288.40 | $288.40 | $616.60 |
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 $154.88 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $154.88 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $229.09 | $251.19 |
Where Maryland sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$324
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.