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 $251.19 Median $371.54 Typical High $467.74 | Professional | None | $251.19 | $371.54 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | None | $245.47 | $275.42 | $275.42 |
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 $239.88 Median $380.19 Typical High $831.76 | Professional | None | $239.88 | $380.19 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $1,258.93 | Professional | None | $398.11 | $446.68 | $1,258.93 |
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 $436.52 Median $602.56 Typical High $1,288.25 | Professional | None | $436.52 | $602.56 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $602.56 | Professional | None | $389.05 | $389.05 | $602.56 |
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 $125.89 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $125.89 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $50.12 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $275.42 Typical High $295.12 | Professional | 54 · Surgery only | $190.55 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $38.02 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.12 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $257.04 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $177.83 | $257.04 | $275.42 |
Where Maryland sits
The same service costs 4.0 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· 48th of 51
$398
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.