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 $177.83 Median $229.09 Typical High $309.03 | Professional | None | $177.83 | $229.09 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | None | $147.91 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $524.81 | Facility | None | $162.18 | $263.03 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $263.03 | Professional | None | $134.90 | $204.17 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $407.38 | Professional | None | $239.88 | $269.15 | $407.38 |
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 $114.82 Median $186.21 Typical High $338.84 | Professional | None | $114.82 | $186.21 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $398.11 | Professional | None | $177.83 | $177.83 | $398.11 |
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 $89.13 Median $100.00 Typical High $154.88 | Professional | 52 · Reduced service | $89.13 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $61.66 | Professional | 53 · Discontinued | $35.48 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $147.91 Typical High $234.42 | Professional | 54 · Surgery only | $131.83 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $46.77 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $138.04 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $123.03 | $138.04 | $218.78 |
Where Maryland sits
The same service costs 4.2 times more in Wyoming 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· 48th of 51
$191
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.