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 $501.19 Median $512.86 Typical High $537.03 | Professional | None | $501.19 | $512.86 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | None | $501.19 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $602.56 | Facility | None | $125.89 | $204.17 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $912.01 | Professional | None | $457.09 | $512.86 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,000.00 | Professional | None | $575.44 | $660.69 | $1,000.00 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,096.48 | Professional | None | $380.19 | $478.63 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $891.25 | Professional | None | $467.74 | $467.74 | $891.25 |
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 $251.19 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $251.19 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $100.00 | $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 $50.12 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $50.12 | $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 5.9 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· 44th 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.