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 $269.15 Median $281.84 Typical High $363.08 | Professional | None | $269.15 | $281.84 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | None | $269.15 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,659.59 Typical High $2,691.53 | Facility | None | $331.13 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $489.78 | Professional | None | $239.88 | $275.42 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $489.78 | Professional | None | $269.15 | $309.03 | $489.78 |
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 $229.09 Median $275.42 Typical High $602.56 | Professional | None | $229.09 | $275.42 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $407.38 | Professional | None | $269.15 | $269.15 | $407.38 |
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 $134.90 Median $134.90 Typical High $141.25 | Professional | 52 · Reduced service | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | 53 · Discontinued | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 54 · Surgery only | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $194.98 |
Where Maryland sits
The same service costs 5.0 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· 47th of 51
$282
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.