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 $457.09 Median $457.09 Typical High $478.63 | Professional | None | $457.09 | $457.09 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | None | $457.09 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $2,691.53 | Facility | None | $512.86 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $812.83 | Professional | None | $407.38 | $457.09 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $812.83 | Professional | None | $457.09 | $512.86 | $812.83 |
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 $354.81 Median $446.68 Typical High $977.24 | Professional | None | $354.81 | $446.68 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $691.83 | Professional | None | $436.52 | $436.52 | $691.83 |
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 $223.87 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 54 · Surgery only | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $331.13 |
Where Maryland sits
The same service costs 6.5 times more in Alaska than in Utah. 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· 42nd of 51
$479
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.