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 $346.74 Median $346.74 Typical High $363.08 | Professional | None | $346.74 | $346.74 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | None | $346.74 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $3,019.95 | Facility | None | $630.96 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $616.60 | Professional | None | $302.00 | $346.74 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $616.60 | Professional | None | $354.81 | $398.11 | $616.60 |
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 $239.88 Median $323.59 Typical High $724.44 | Professional | None | $239.88 | $323.59 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $537.03 | Professional | None | $295.12 | $295.12 | $537.03 |
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 $169.82 Median $169.82 Typical High $181.97 | Professional | 52 · Reduced service | $169.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 53 · Discontinued | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $257.04 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $257.04 |
Where Maryland sits
The same service costs 6.8 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
$363
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.