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 $104.71 Median $141.25 Typical High $173.78 | Professional | None | $104.71 | $141.25 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $107.15 | Professional | None | $95.50 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,122.02 Typical High $1,862.09 | Facility | None | $331.13 | $1,122.02 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $316.23 | Professional | None | $102.33 | $151.36 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $257.04 | Professional | None | $151.36 | $181.97 | $257.04 |
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 $89.13 Median $158.49 Typical High $302.00 | Professional | None | $89.13 | $158.49 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $239.88 | Professional | None | $109.65 | $109.65 | $239.88 |
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 $52.48 Median $63.10 Typical High $87.10 | Professional | 52 · Reduced service | $52.48 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $20.89 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $95.50 Typical High $128.82 | Professional | 54 · Surgery only | $79.43 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.47 | $12.59 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $89.13 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $74.13 | $89.13 | $120.23 |
Where Maryland sits
The same service costs 4.7 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· 33rd of 51
$162
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.