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 $407.38 Median $426.58 Typical High $467.74 | Professional | None | $407.38 | $426.58 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | None | $416.87 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $1,584.89 | Facility | None | $446.68 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $794.33 | Professional | None | $371.54 | $426.58 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $891.25 | Professional | None | $524.81 | $602.56 | $891.25 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $912.01 | Professional | None | $302.00 | $389.05 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $812.83 | Professional | None | $380.19 | $380.19 | $812.83 |
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 $204.17 Median $213.80 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $331.13 |
Where Maryland sits
The same service costs 5.6 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· 44th 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.