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 $138.04 Median $204.17 Typical High $251.19 | Professional | None | $138.04 | $204.17 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | None | $131.83 | $144.54 | $144.54 |
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 $138.04 Median $208.93 Typical High $426.58 | Professional | None | $138.04 | $208.93 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $371.54 | Professional | None | $213.80 | $251.19 | $371.54 |
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 $123.03 Median $213.80 Typical High $407.38 | Professional | None | $123.03 | $213.80 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $331.13 | Professional | None | $144.54 | $144.54 | $331.13 |
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 $69.18 Median $87.10 Typical High $117.49 | Professional | 52 · Reduced service | $69.18 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $28.18 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $131.83 Typical High $173.78 | Professional | 54 · Surgery only | $104.71 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.30 Typical High $34.67 | Professional | 55 · Aftercare only | $20.89 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $13.80 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $123.03 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $97.72 | $123.03 | $162.18 |
Where Maryland sits
The same service costs 4.1 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· 31st of 51
$224
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.