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 $281.84 Median $281.84 Typical High $295.12 | Professional | None | $281.84 | $281.84 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $323.59 | Professional | None | $234.42 | $263.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $2,691.53 | Facility | None | $630.96 | $1,513.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $389.05 | Professional | None | $229.09 | $263.03 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $371.54 | Professional | None | $223.87 | $251.19 | $371.54 |
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 $190.55 Median $229.09 Typical High $436.52 | Professional | None | $190.55 | $229.09 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $302.00 | Professional | None | $194.98 | $194.98 | $302.00 |
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 $141.25 Median $141.25 Typical High $147.91 | Professional | 52 · Reduced service | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 53 · Discontinued | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | 54 · Surgery only | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $204.17 |
Where Maryland sits
The same service costs 6.0 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· 40th of 51
$263
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.