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 $229.09 Median $281.84 Typical High $363.08 | Professional | None | $229.09 | $281.84 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $223.87 | Professional | None | $194.98 | $213.80 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $562.34 | Facility | None | $275.42 | $331.13 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $660.69 | Professional | None | $204.17 | $323.59 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $660.69 | Professional | None | $309.03 | $389.05 | $660.69 |
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 $223.87 Median $380.19 Typical High $724.44 | Professional | None | $223.87 | $380.19 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $512.86 | Professional | None | $275.42 | $275.42 | $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 $114.82 Median $131.83 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $199.53 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $39.81 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $186.21 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $186.21 | $251.19 |
Where Maryland sits
The same service costs 3.7 times more in Wisconsin 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· 45th 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.