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 $190.55 Median $239.88 Typical High $316.23 | Professional | None | $190.55 | $239.88 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $190.55 | Professional | None | $158.49 | $177.83 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $436.52 | Facility | None | $190.55 | $309.03 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $549.54 | Professional | None | $165.96 | $269.15 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $501.19 | Professional | None | $234.42 | $316.23 | $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 $162.18 Median $288.40 Typical High $549.54 | Professional | None | $162.18 | $288.40 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $426.58 | Professional | None | $218.78 | $218.78 | $426.58 |
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 $95.50 Median $102.33 Typical High $158.49 | Professional | 52 · Reduced service | $95.50 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $64.57 | Professional | 53 · Discontinued | $38.02 | $40.74 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $151.36 Typical High $239.88 | Professional | 54 · Surgery only | $141.25 | $151.36 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.20 Typical High $47.86 | Professional | 55 · Aftercare only | $28.18 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $141.25 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $131.83 | $141.25 | $223.87 |
Where Maryland sits
The same service costs 4.3 times more in Wisconsin than in Kentucky. 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· 38th of 51
$275
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.