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 $512.86 Median $537.03 Typical High $537.03 | Professional | None | $512.86 | $537.03 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | None | $512.86 | $575.44 | $575.44 |
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 $446.68 Median $512.86 Typical High $912.01 | Professional | None | $446.68 | $512.86 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $912.01 | Professional | None | $512.86 | $588.84 | $912.01 |
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 $354.81 Median $467.74 Typical High $1,071.52 | Professional | None | $354.81 | $467.74 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $794.33 | Professional | None | $416.87 | $416.87 | $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 $257.04 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $380.19 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $380.19 |
Where Maryland sits
The same service costs 6.9 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· 39th of 51
$537
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.