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 $331.13 Median $446.68 Typical High $562.34 | Professional | None | $331.13 | $446.68 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | None | $323.59 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $758.58 Typical High $1,348.96 | Facility | None | $446.68 | $758.58 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $794.33 | Professional | None | $295.12 | $436.52 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,023.29 | Professional | None | $588.84 | $660.69 | $1,023.29 |
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 $154.88 Median $316.23 Typical High $912.01 | Professional | None | $154.88 | $316.23 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $912.01 | Professional | None | $380.19 | $380.19 | $912.01 |
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 $165.96 Median $181.97 Typical High $275.42 | Professional | 52 · Reduced service | $165.96 | $181.97 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $112.20 | Professional | 53 · Discontinued | $66.07 | $74.13 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $416.87 | Professional | 54 · Surgery only | $245.47 | $275.42 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $83.18 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $389.05 |
Where Maryland sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$380
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.