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 $478.63 Median $501.19 Typical High $549.54 | Professional | None | $478.63 | $501.19 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | None | $478.63 | $537.03 | $537.03 |
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 $436.52 Median $512.86 Typical High $912.01 | Professional | None | $436.52 | $512.86 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,071.52 | Professional | None | $645.65 | $741.31 | $1,071.52 |
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 $354.81 Median $467.74 Typical High $1,122.02 | Professional | None | $354.81 | $467.74 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,023.29 | Professional | None | $457.09 | $457.09 | $1,023.29 |
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 $239.88 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $389.05 |
Where Maryland sits
The same service costs 5.0 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· 45th of 51
$501
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.