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 $338.84 Median $436.52 Typical High $537.03 | Professional | None | $338.84 | $436.52 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | None | $346.74 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $891.25 Typical High $1,584.89 | Facility | None | $331.13 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $707.95 | Professional | None | $316.23 | $407.38 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $831.76 | Professional | None | $489.78 | $562.34 | $831.76 |
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 $263.03 Median $389.05 Typical High $870.96 | Professional | None | $263.03 | $389.05 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $758.58 | Professional | None | $323.59 | $323.59 | $758.58 |
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 $169.82 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $169.82 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $346.74 | Professional | 54 · Surgery only | $257.04 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $69.18 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $269.15 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $239.88 | $269.15 | $323.59 |
Where Maryland sits
The same service costs 4.9 times more in Alaska 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· 46th of 51
$389
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.