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 $346.74 | Professional | None | $309.03 | $331.13 | $346.74 |
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 $323.59 Typical High $588.84 | Professional | None | $281.84 | $323.59 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $645.65 | Professional | None | $380.19 | $426.58 | $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 $229.09 Median $295.12 Typical High $676.08 | Professional | None | $229.09 | $295.12 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $588.84 | Professional | None | $281.84 | $281.84 | $588.84 |
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 $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $63.10 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $257.04 | Professional | 54 · Surgery only | $234.42 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $239.88 |
Where Maryland sits
The same service costs 5.5 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
$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.