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 $446.68 Median $478.63 Typical High $524.81 | Professional | None | $446.68 | $478.63 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | None | $446.68 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $891.25 Typical High $1,584.89 | Facility | None | $331.13 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $851.14 | Professional | None | $416.87 | $478.63 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $977.24 | Professional | None | $616.60 | $707.95 | $977.24 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $1,023.29 | Professional | None | $338.84 | $446.68 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $977.24 | Professional | None | $446.68 | $446.68 | $977.24 |
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 $223.87 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $363.08 |
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· 43rd 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.