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 $323.59 Median $331.13 Typical High $346.74 | Professional | None | $323.59 | $331.13 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $371.54 | Professional | None | $331.13 | $371.54 | $371.54 |
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 $288.40 Median $331.13 Typical High $588.84 | Professional | None | $288.40 | $331.13 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $588.84 | Professional | None | $331.13 | $380.19 | $588.84 |
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 $223.87 Median $309.03 Typical High $691.83 | Professional | None | $223.87 | $309.03 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $512.86 | Professional | None | $275.42 | $275.42 | $512.86 |
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 $162.18 Median $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | 54 · Surgery only | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $239.88 |
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
$347
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.