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 $257.04 Median $302.00 Typical High $363.08 | Professional | None | $257.04 | $302.00 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $295.12 | Professional | None | $213.80 | $239.88 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $1,202.26 | Facility | None | $446.68 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $416.87 | Professional | None | $223.87 | $302.00 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $489.78 | Professional | None | $275.42 | $346.74 | $489.78 |
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 $199.53 Median $269.15 Typical High $501.19 | Professional | None | $199.53 | $269.15 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $416.87 | Professional | None | $239.88 | $239.88 | $416.87 |
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 $128.82 Median $138.04 Typical High $181.97 | Professional | 52 · Reduced service | $128.82 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $208.93 Typical High $275.42 | Professional | 54 · Surgery only | $194.98 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $41.69 Typical High $54.95 | Professional | 55 · Aftercare only | $38.90 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $194.98 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $181.97 | $194.98 | $257.04 |
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· 45th of 51
$269
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.