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 $501.19 Median $549.54 Typical High $616.60 | Professional | None | $501.19 | $549.54 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | None | $501.19 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $1,584.89 | Facility | None | $446.68 | $891.25 | $1,584.89 |
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 $630.96 Median $724.44 Typical High $1,096.48 | Professional | None | $630.96 | $724.44 | $1,096.48 |
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 $380.19 Median $501.19 Typical High $1,174.90 | Professional | None | $380.19 | $501.19 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,000.00 | Professional | None | $512.86 | $512.86 | $1,000.00 |
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 $251.19 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $407.38 |
Where Maryland sits
The same service costs 5.6 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
$537
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.