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 $371.54 Median $426.58 Typical High $549.54 | Professional | None | $371.54 | $426.58 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $426.58 | Professional | None | $309.03 | $346.74 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,951.21 Typical High $5,011.87 | Facility | None | $446.68 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $616.60 | Professional | None | $323.59 | $446.68 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $741.31 | Professional | None | $426.58 | $537.03 | $741.31 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $776.25 | Professional | None | $302.00 | $416.87 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $645.65 | Professional | None | $281.84 | $281.84 | $645.65 |
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 $186.21 Median $208.93 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $275.42 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $380.19 |
Where Maryland sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$389
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.