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 $354.81 Median $354.81 Typical High $371.54 | Professional | None | $354.81 | $354.81 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | None | $363.08 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,691.53 | Facility | None | $446.68 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $645.65 | Professional | None | $316.23 | $363.08 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $630.96 | Professional | None | $371.54 | $416.87 | $630.96 |
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 $263.03 Median $338.84 Typical High $741.31 | Professional | None | $263.03 | $338.84 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $562.34 | Professional | None | $323.59 | $323.59 | $562.34 |
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 $177.83 Median $177.83 Typical High $186.21 | Professional | 52 · Reduced service | $177.83 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | 53 · Discontinued | $70.79 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $37.15 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $263.03 |
Where Maryland sits
The same service costs 7.4 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
$372
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.