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 $229.09 Median $251.19 Typical High $323.59 | Facility | None | $229.09 | $251.19 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $363.08 | Professional | None | $181.97 | $239.88 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
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 $181.97 Median $239.88 Typical High $549.54 | Professional | None | $181.97 | $239.88 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $426.58 | Professional | None | $234.42 | $275.42 | $426.58 |
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 $162.18 Median $257.04 Typical High $524.81 | Professional | None | $162.18 | $257.04 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $363.08 | Professional | None | $173.78 | $173.78 | $363.08 |
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 $91.20 Median $100.00 Typical High $131.83 | Professional | 52 · Reduced service | $91.20 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $40.74 Typical High $52.48 | Professional | 53 · Discontinued | $36.31 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $138.04 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.20 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $141.25 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $128.82 | $141.25 | $186.21 |
Where Maryland sits
The same service costs 4.6 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
$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.