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 $354.81 Median $524.81 Typical High $562.34 | Professional | None | $354.81 | $524.81 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $977.24 Typical High $1,819.70 | Facility | None | $630.96 | $977.24 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $812.83 | Professional | None | $338.84 | $501.19 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,000.00 | Professional | None | $575.44 | $660.69 | $1,000.00 |
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 $288.40 Median $446.68 Typical High $977.24 | Professional | None | $288.40 | $446.68 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $891.25 | Professional | None | $467.74 | $467.74 | $891.25 |
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 $177.83 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $177.83 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $89.13 Typical High $112.20 | Professional | 53 · Discontinued | $70.79 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $331.13 Typical High $416.87 | Professional | 54 · Surgery only | $263.03 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $53.70 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $35.48 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $309.03 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $245.47 | $309.03 | $389.05 |
Where Maryland sits
The same service costs 4.8 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
$468
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.