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 $239.88 Typical High $257.04 | Professional | None | $138.04 | $239.88 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | None | $138.04 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,949.84 Typical High $3,311.31 | Facility | None | $331.13 | $1,949.84 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $389.05 | Professional | None | $128.82 | $213.80 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $467.74 | Professional | None | $269.15 | $302.00 | $467.74 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $501.19 | Professional | None | $125.89 | $239.88 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $416.87 | Professional | None | $251.19 | $251.19 | $416.87 |
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 $91.20 Typical High $128.82 | Professional | 52 · Reduced service | $69.18 | $91.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $36.31 Typical High $51.29 | Professional | 53 · Discontinued | $27.54 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $138.04 Typical High $190.55 | Professional | 54 · Surgery only | $104.71 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $27.54 Typical High $38.02 | Professional | 55 · Aftercare only | $20.89 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.20 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.80 | $18.20 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $128.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $97.72 | $128.82 | $177.83 |
Where Maryland sits
The same service costs 3.8 times more in Alaska than in Texas. 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· 42nd of 51
$229
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.