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 $467.74 Median $616.60 Typical High $707.95 | Professional | None | $467.74 | $616.60 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | None | $478.63 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $676.08 | Facility | None | $120.23 | $194.98 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,096.48 | Professional | None | $457.09 | $645.65 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,288.25 | Professional | None | $758.58 | $851.14 | $1,288.25 |
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 $446.68 Median $630.96 Typical High $1,348.96 | Professional | None | $446.68 | $630.96 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $1,148.15 | Professional | None | $446.68 | $446.68 | $1,148.15 |
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 $234.42 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $93.33 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $354.81 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $91.20 Typical High $104.71 | Professional | 55 · Aftercare only | $70.79 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $61.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $426.58 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $331.13 | $426.58 | $489.78 |
Where Maryland sits
The same service costs 3.6 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
$537
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.