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 $169.82 Median $194.98 Typical High $380.19 | Professional | None | $169.82 | $194.98 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | None | $128.82 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $1,949.84 | Facility | None | $446.68 | $1,096.48 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $288.40 | Professional | None | $125.89 | $229.09 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $446.68 | Professional | None | $281.84 | $323.59 | $446.68 |
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 $107.15 Median $199.53 Typical High $363.08 | Professional | None | $107.15 | $199.53 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $467.74 | Professional | None | $208.93 | $208.93 | $467.74 |
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 $85.11 Median $95.50 Typical High $190.55 | Professional | 52 · Reduced service | $85.11 | $95.50 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $75.86 | Professional | 53 · Discontinued | $33.88 | $38.90 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $281.84 | Professional | 54 · Surgery only | $125.89 | $144.54 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $56.23 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.50 Typical High $38.02 | Professional | 56 · Pre-op care only | $16.98 | $19.50 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $263.03 |
Where Maryland sits
The same service costs 6.0 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· 48th of 51
$219
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.