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 $398.11 Median $416.87 Typical High $416.87 | Professional | None | $398.11 | $416.87 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | None | $398.11 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $2,691.53 | Facility | None | $512.86 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $724.44 | Professional | None | $354.81 | $398.11 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $724.44 | Professional | None | $398.11 | $446.68 | $724.44 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $870.96 | Professional | None | $323.59 | $389.05 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Professional | None | $398.11 | $398.11 | $602.56 |
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 $199.53 Median $199.53 Typical High $208.93 | Professional | 52 · Reduced service | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $295.12 |
Where Maryland sits
The same service costs 6.3 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· 43rd of 51
$417
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.