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 $316.23 Median $346.74 Typical High $371.54 | Professional | None | $316.23 | $346.74 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | None | $323.59 | $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 $331.13 Typical High $602.56 | Professional | None | $281.84 | $331.13 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $691.83 | Professional | None | $407.38 | $457.09 | $691.83 |
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 $707.95 | Professional | None | $223.87 | $302.00 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $630.96 | Professional | None | $295.12 | $295.12 | $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 $154.88 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $154.88 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $63.10 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $234.42 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $46.77 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $218.78 | $234.42 | $257.04 |
Where Maryland sits
The same service costs 5.9 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· 40th of 51
$331
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.