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 $501.19 Median $501.19 Typical High $524.81 | Professional | None | $501.19 | $501.19 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | None | $512.86 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $891.25 Typical High $1,584.89 | Facility | None | $331.13 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $891.25 | Professional | None | $446.68 | $512.86 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $891.25 | Professional | None | $512.86 | $575.44 | $891.25 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $1,047.13 | Professional | None | $354.81 | $467.74 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $794.33 | Professional | None | $436.52 | $436.52 | $794.33 |
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 $251.19 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 53 · Discontinued | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $371.54 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $52.48 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $371.54 |
Where Maryland sits
The same service costs 7.6 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· 40th of 51
$513
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.