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 $489.78 | Professional | None | $457.09 | $457.09 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | None | $467.74 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $436.52 | Facility | None | $125.89 | $204.17 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $831.76 | Professional | None | $380.19 | $467.74 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $812.83 | Professional | None | $478.63 | $537.03 | $812.83 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $891.25 | Professional | None | $302.00 | $398.11 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $724.44 | Professional | None | $371.54 | $371.54 | $724.44 |
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 $229.09 Median $229.09 Typical High $239.88 | Professional | 52 · Reduced service | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $338.84 |
Where Maryland sits
The same service costs 7.9 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· 36th 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.