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 Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $436.52 | Facility | None | $208.93 | $234.42 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $389.05 | Professional | None | $208.93 | $223.87 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $218.78 | Professional | None | $162.18 | $181.97 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $426.58 Typical High $676.08 | Facility | None | $275.42 | $426.58 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $389.05 | Professional | None | $177.83 | $275.42 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $575.44 | Professional | None | $288.40 | $398.11 | $575.44 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $426.58 | Professional | None | $104.71 | $194.98 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $489.78 | Professional | None | $151.36 | $151.36 | $489.78 |
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 $104.71 Median $112.20 Typical High $194.98 | Professional | 52 · Reduced service | $104.71 | $112.20 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $77.62 | Professional | 53 · Discontinued | $41.69 | $44.67 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $165.96 Typical High $288.40 | Professional | 54 · Surgery only | $158.49 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $58.88 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $154.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $147.91 | $154.88 | $269.15 |
Where Maryland sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$209
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.