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 $165.96 Median $190.55 Typical High $354.81 | Professional | None | $165.96 | $190.55 | $354.81 |
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 $562.34 Typical High $1,000.00 | Facility | None | $446.68 | $562.34 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $295.12 | Professional | None | $123.03 | $239.88 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $467.74 | Professional | None | $269.15 | $309.03 | $467.74 |
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 $107.15 Median $204.17 Typical High $354.81 | Professional | None | $107.15 | $204.17 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $446.68 | Professional | None | $208.93 | $208.93 | $446.68 |
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 $81.28 Median $95.50 Typical High $177.83 | Professional | 52 · Reduced service | $81.28 | $95.50 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.02 Typical High $72.44 | Professional | 53 · Discontinued | $33.11 | $38.02 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $141.25 Typical High $269.15 | Professional | 54 · Surgery only | $123.03 | $141.25 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.18 Typical High $53.70 | Professional | 55 · Aftercare only | $24.55 | $28.18 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.05 Typical High $35.48 | Professional | 56 · Pre-op care only | $16.60 | $19.05 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $131.83 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $114.82 | $131.83 | $251.19 |
Where Maryland sits
The same service costs 4.7 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· 45th 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.