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 $489.78 Median $489.78 Typical High $512.86 | Professional | None | $489.78 | $489.78 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | None | $501.19 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,691.53 | Facility | None | $446.68 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $891.25 | Professional | None | $436.52 | $501.19 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $870.96 | Professional | None | $501.19 | $562.34 | $870.96 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $1,023.29 | Professional | None | $363.08 | $457.09 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $776.25 | Professional | None | $446.68 | $446.68 | $776.25 |
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 $245.47 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $363.08 |
Where Maryland sits
The same service costs 7.1 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.