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 $371.54 Median $371.54 Typical High $398.11 | Professional | None | $371.54 | $371.54 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | None | $380.19 | $426.58 | $426.58 |
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 $331.13 Median $380.19 Typical High $676.08 | Professional | None | $331.13 | $380.19 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $660.69 | Professional | None | $389.05 | $436.52 | $660.69 |
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 $288.40 Median $363.08 Typical High $758.58 | Professional | None | $288.40 | $363.08 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $588.84 | Professional | None | $354.81 | $354.81 | $588.84 |
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 $186.21 Median $186.21 Typical High $199.53 | Professional | 52 · Reduced service | $186.21 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $74.13 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $275.42 |
Where Maryland sits
The same service costs 7.1 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· 40th of 51
$398
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.