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 $524.81 Typical High $562.34 | Professional | None | $489.78 | $524.81 | $562.34 |
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 $436.52 | Facility | None | $125.89 | $204.17 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $954.99 | Professional | None | $446.68 | $512.86 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,047.13 | Professional | None | $602.56 | $691.83 | $1,047.13 |
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 $363.08 Median $467.74 Typical High $1,096.48 | Professional | None | $363.08 | $467.74 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $933.25 | Professional | None | $426.58 | $426.58 | $933.25 |
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 $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $371.54 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $389.05 |
Where Maryland sits
The same service costs 5.8 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· 39th 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.