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 $302.00 Median $371.54 Typical High $575.44 | Professional | None | $302.00 | $371.54 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | None | $245.47 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $181.97 Typical High $331.13 | Facility | None | $50.12 | $181.97 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $478.63 | Professional | None | $229.09 | $389.05 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $741.31 | Professional | None | $436.52 | $501.19 | $741.31 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $616.60 | Professional | None | $204.17 | $331.13 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $724.44 | Professional | None | $338.84 | $338.84 | $724.44 |
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 $151.36 Median $173.78 Typical High $281.84 | Professional | 52 · Reduced service | $151.36 | $173.78 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $114.82 | Professional | 53 · Discontinued | $60.26 | $69.18 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $263.03 Typical High $426.58 | Professional | 54 · Surgery only | $223.87 | $263.03 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $52.48 Typical High $85.11 | Professional | 55 · Aftercare only | $44.67 | $52.48 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $57.54 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $245.47 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $208.93 | $245.47 | $398.11 |
Where Maryland sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 51st of 51
$302
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.