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 $457.09 Median $489.78 Typical High $524.81 | Professional | None | $457.09 | $489.78 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | None | $467.74 | $512.86 | $512.86 |
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 $416.87 Median $478.63 Typical High $891.25 | Professional | None | $416.87 | $478.63 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $977.24 | Professional | None | $562.34 | $645.65 | $977.24 |
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 $338.84 Median $426.58 Typical High $1,023.29 | Professional | None | $338.84 | $426.58 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $891.25 | Professional | None | $426.58 | $426.58 | $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 $229.09 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $363.08 |
Where Maryland sits
The same service costs 5.4 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
$479
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.