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 $269.15 Typical High $323.59 | Professional | None | $223.87 | $269.15 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | None | $190.55 | $213.80 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $676.08 Typical High $1,202.26 | Facility | None | $331.13 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $575.44 | Professional | None | $204.17 | $295.12 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $501.19 | Professional | None | $295.12 | $338.84 | $501.19 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $588.84 | Professional | None | $204.17 | $346.74 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $457.09 | Professional | None | $257.04 | $257.04 | $457.09 |
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 $162.18 | Professional | 52 · Reduced service | $112.20 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $52.48 Typical High $64.57 | Professional | 53 · Discontinued | $44.67 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $165.96 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $33.88 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.30 Typical High $32.36 | Professional | 56 · Pre-op care only | $22.39 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $229.09 |
Where Maryland sits
The same service costs 4.3 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· 37th 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.