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 $389.05 Median $407.38 Typical High $501.19 | Professional | None | $389.05 | $407.38 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | None | $398.11 | $436.52 | $436.52 |
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 $346.74 Median $398.11 Typical High $691.83 | Professional | None | $346.74 | $398.11 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $691.83 | Professional | None | $389.05 | $446.68 | $691.83 |
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 $295.12 Median $371.54 Typical High $812.83 | Professional | None | $295.12 | $371.54 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
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 $194.98 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $288.40 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $288.40 |
Where Maryland sits
The same service costs 7.2 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· 42nd of 51
$407
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.