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 $489.78 Median $489.78 Typical High $524.81 | Professional | None | $489.78 | $489.78 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | None | $501.19 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $3,019.95 | Facility | None | $630.96 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $891.25 | Professional | None | $436.52 | $501.19 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $870.96 | Professional | None | $489.78 | $562.34 | $870.96 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,047.13 | Professional | None | $380.19 | $478.63 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $758.58 | Professional | None | $467.74 | $467.74 | $758.58 |
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 $245.47 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $371.54 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $363.08 |
Where Maryland sits
The same service costs 6.2 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· 41st of 51
$525
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.