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 $524.81 Median $537.03 Typical High $549.54 | Professional | None | $524.81 | $537.03 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $616.60 | Professional | None | $524.81 | $588.84 | $616.60 |
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 $467.74 Median $537.03 Typical High $954.99 | Professional | None | $467.74 | $537.03 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $954.99 | Professional | None | $524.81 | $602.56 | $954.99 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $1,148.15 | Professional | None | $436.52 | $524.81 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $812.83 | Professional | None | $537.03 | $537.03 | $812.83 |
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 $263.03 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | 54 · Surgery only | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $380.19 |
Where Maryland sits
The same service costs 7.4 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· 44th of 51
$550
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.