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 $181.97 Median $407.38 Typical High $467.74 | Professional | None | $181.97 | $407.38 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | None | $177.83 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $977.24 Typical High $1,659.59 | Facility | None | $436.52 | $977.24 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $380.19 Typical High $616.60 | Professional | None | $169.82 | $380.19 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $851.14 | Professional | None | $489.78 | $549.54 | $851.14 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $741.31 | Professional | None | $208.93 | $398.11 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $758.58 | Professional | None | $446.68 | $446.68 | $758.58 |
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 $141.25 Typical High $234.42 | Professional | 52 · Reduced service | $91.20 | $141.25 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $56.23 Typical High $93.33 | Professional | 53 · Discontinued | $36.31 | $56.23 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $208.93 Typical High $346.74 | Professional | 54 · Surgery only | $138.04 | $208.93 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $69.18 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.18 Typical High $46.77 | Professional | 56 · Pre-op care only | $18.20 | $28.18 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $194.98 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $128.82 | $194.98 | $323.59 |
Where Maryland sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 40th of 51
$380
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.