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 $512.86 Typical High $537.03 | Professional | None | $512.86 | $512.86 | $537.03 |
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 $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 $457.09 Median $512.86 Typical High $933.25 | Professional | None | $457.09 | $512.86 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $912.01 | Professional | None | $524.81 | $602.56 | $912.01 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $1,096.48 | Professional | None | $380.19 | $489.78 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $812.83 | Professional | None | $457.09 | $457.09 | $812.83 |
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 $389.05 Median $389.05 Typical High $407.38 | Professional | 54 · Surgery only | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $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 $363.08 Median $363.08 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $380.19 |
Where Maryland sits
The same service costs 5.8 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
$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.