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 $275.42 Median $309.03 Typical High $323.59 | Professional | None | $275.42 | $309.03 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | None | $281.84 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $1,659.59 | Facility | None | $512.86 | $891.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $549.54 | Professional | None | $269.15 | $309.03 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $645.65 | Professional | None | $338.84 | $389.05 | $645.65 |
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 $239.88 Median $302.00 Typical High $676.08 | Professional | None | $239.88 | $302.00 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $524.81 | Professional | None | $309.03 | $309.03 | $524.81 |
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 $134.90 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $204.17 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $190.55 | $204.17 | $229.09 |
Where Maryland sits
The same service costs 6.8 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· 43rd of 51
$309
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.