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 $524.81 Typical High $575.44 | Professional | None | $331.13 | $524.81 | $575.44 |
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 $309.03 Median $478.63 Typical High $812.83 | Professional | None | $309.03 | $478.63 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,047.13 | Professional | None | $602.56 | $691.83 | $1,047.13 |
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 $251.19 Median $416.87 Typical High $954.99 | Professional | None | $251.19 | $416.87 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $954.99 | Professional | None | $436.52 | $436.52 | $954.99 |
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 $213.80 Typical High $288.40 | Professional | 52 · Reduced service | $165.96 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $114.82 | Professional | 53 · Discontinued | $66.07 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $436.52 | Professional | 54 · Surgery only | $251.19 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $87.10 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $407.38 |
Where Maryland sits
The same service costs 4.4 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
$437
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.