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 $223.87 Median $263.03 Typical High $354.81 | Professional | None | $223.87 | $263.03 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $218.78 | Professional | None | $190.55 | $213.80 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $426.58 Typical High $602.56 | Facility | None | $275.42 | $426.58 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $616.60 | Professional | None | $204.17 | $316.23 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $537.03 | Professional | None | $295.12 | $380.19 | $537.03 |
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 $199.53 Median $346.74 Typical High $630.96 | Professional | None | $199.53 | $346.74 | $630.96 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $512.86 | Professional | None | $257.04 | $257.04 | $512.86 |
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 $112.20 Median $131.83 Typical High $173.78 | Professional | 52 · Reduced service | $112.20 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $52.48 Typical High $70.79 | Professional | 53 · Discontinued | $44.67 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $165.96 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $245.47 |
Where Maryland sits
The same service costs 3.7 times more in Wisconsin 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· 41st of 51
$295
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.