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 $177.83 Median $309.03 Typical High $354.81 | Professional | None | $177.83 | $309.03 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $891.25 Typical High $1,584.89 | Facility | None | $331.13 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $309.03 Typical High $512.86 | Professional | None | $173.78 | $309.03 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $630.96 | Professional | None | $354.81 | $407.38 | $630.96 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $616.60 | Professional | None | $154.88 | $295.12 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $562.34 | Professional | None | $338.84 | $338.84 | $562.34 |
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 $89.13 Median $123.03 Typical High $173.78 | Professional | 52 · Reduced service | $89.13 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $48.98 Typical High $70.79 | Professional | 53 · Discontinued | $35.48 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $52.48 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $24.55 Typical High $35.48 | Professional | 56 · Pre-op care only | $17.78 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $173.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $125.89 | $173.78 | $245.47 |
Where Maryland sits
The same service costs 3.8 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· 41st of 51
$302
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.