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 $436.52 Median $446.68 Typical High $467.74 | Professional | None | $436.52 | $446.68 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | None | $446.68 | $501.19 | $501.19 |
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 $398.11 Median $446.68 Typical High $851.14 | Professional | None | $398.11 | $446.68 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $794.33 | Professional | None | $436.52 | $501.19 | $794.33 |
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 $371.54 Median $467.74 Typical High $1,023.29 | Professional | None | $371.54 | $467.74 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $676.08 | Professional | None | $436.52 | $436.52 | $676.08 |
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 $218.78 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $218.78 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $87.10 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 54 · Surgery only | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $323.59 |
Where Maryland sits
The same service costs 6.3 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· 44th of 51
$468
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.