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 $316.23 Median $380.19 Typical High $457.09 | Professional | None | $316.23 | $380.19 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | None | $302.00 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,258.93 Typical High $2,187.76 | Facility | None | $446.68 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $575.44 | Professional | None | $302.00 | $363.08 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $794.33 | Professional | None | $416.87 | $467.74 | $794.33 |
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 $269.15 Median $371.54 Typical High $794.33 | Professional | None | $269.15 | $371.54 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $645.65 | Professional | None | $309.03 | $309.03 | $645.65 |
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 $158.49 Median $158.49 Typical High $194.98 | Professional | 52 · Reduced service | $158.49 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $63.10 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $295.12 | Professional | 54 · Surgery only | $234.42 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $58.88 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $38.90 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $223.87 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $218.78 | $223.87 | $275.42 |
Where Maryland sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 40th of 51
$372
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.