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 $389.05 Median $524.81 Typical High $562.34 | Professional | None | $389.05 | $524.81 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | None | $389.05 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,258.93 Typical High $2,187.76 | Facility | None | $446.68 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $851.14 | Professional | None | $371.54 | $501.19 | $851.14 |
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 $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 $302.00 Median $457.09 Typical High $1,023.29 | Professional | None | $302.00 | $457.09 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $891.25 | Professional | None | $489.78 | $489.78 | $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 $194.98 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $194.98 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $89.13 Typical High $112.20 | Professional | 53 · Discontinued | $77.62 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $426.58 | Professional | 54 · Surgery only | $295.12 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $85.11 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $398.11 |
Where Maryland sits
The same service costs 4.8 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· 46th 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.