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 $186.21 Median $223.87 Typical High $281.84 | Professional | None | $186.21 | $223.87 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $218.78 | Professional | None | $165.96 | $181.97 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $676.08 | Facility | None | $144.54 | $229.09 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $323.59 | Professional | None | $165.96 | $234.42 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $380.19 | Professional | None | $213.80 | $269.15 | $380.19 |
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 $144.54 Median $208.93 Typical High $380.19 | Professional | None | $144.54 | $208.93 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $323.59 | Professional | None | $186.21 | $186.21 | $323.59 |
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 $93.33 Median $104.71 Typical High $141.25 | Professional | 52 · Reduced service | $93.33 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $42.66 Typical High $56.23 | Professional | 53 · Discontinued | $37.15 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $213.80 | Professional | 54 · Surgery only | $141.25 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.38 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.62 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $199.53 |
Where Maryland sits
The same service costs 3.8 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· 47th of 51
$195
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.