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 $218.78 Median $323.59 Typical High $436.52 | Professional | None | $218.78 | $323.59 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | None | $169.82 | $190.55 | $190.55 |
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 $162.18 Median $281.84 Typical High $363.08 | Professional | None | $162.18 | $281.84 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $524.81 | Professional | None | $331.13 | $380.19 | $524.81 |
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 $138.04 Median $234.42 Typical High $446.68 | Professional | None | $138.04 | $234.42 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $549.54 | Professional | None | $245.47 | $245.47 | $549.54 |
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 $109.65 Median $125.89 Typical High $218.78 | Professional | 52 · Reduced service | $109.65 | $125.89 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $50.12 Typical High $87.10 | Professional | 53 · Discontinued | $43.65 | $50.12 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $190.55 Typical High $331.13 | Professional | 54 · Surgery only | $162.18 | $190.55 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $66.07 | Professional | 55 · Aftercare only | $32.36 | $38.02 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $43.65 | Professional | 56 · Pre-op care only | $21.88 | $25.12 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $151.36 | $177.83 | $309.03 |
Where Maryland sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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
$263
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.