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 $354.81 Median $457.09 Typical High $489.78 | Professional | None | $354.81 | $457.09 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,513.56 Typical High $2,398.83 | Facility | None | $446.68 | $1,513.56 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $794.33 | Professional | None | $346.74 | $446.68 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $870.96 | Professional | None | $512.86 | $575.44 | $870.96 |
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 $323.59 Median $436.52 Typical High $1,000.00 | Professional | None | $323.59 | $436.52 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $794.33 | Professional | None | $354.81 | $354.81 | $794.33 |
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 $177.83 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $177.83 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $70.79 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $269.15 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $346.74 |
Where Maryland sits
The same service costs 6.0 times more in Alaska than in Texas. 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· 45th of 51
$427
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.