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 $263.03 Median $281.84 Typical High $302.00 | Professional | None | $263.03 | $281.84 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | None | $275.42 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $2,691.53 | Facility | None | $501.19 | $645.65 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $741.31 | Professional | None | $269.15 | $346.74 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $512.86 | Professional | None | $269.15 | $316.23 | $512.86 |
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 $263.03 Median $398.11 Typical High $724.44 | Professional | None | $263.03 | $398.11 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $416.87 | Professional | None | $239.88 | $239.88 | $416.87 |
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 $128.82 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.30 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $199.53 |
Where Maryland sits
The same service costs 5.6 times more in Alaska than in Texas. 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· 46th 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.