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 $302.00 Median $426.58 Typical High $478.63 | Professional | None | $302.00 | $426.58 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | None | $309.03 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $758.58 Typical High $1,348.96 | Facility | None | $446.68 | $758.58 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $707.95 | Professional | None | $295.12 | $436.52 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $851.14 | Professional | None | $478.63 | $549.54 | $851.14 |
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 $257.04 Median $407.38 Typical High $870.96 | Professional | None | $257.04 | $407.38 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $758.58 | Professional | None | $426.58 | $426.58 | $758.58 |
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 $151.36 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $151.36 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $60.26 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $229.09 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $60.26 Typical High $72.44 | Professional | 55 · Aftercare only | $45.71 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.20 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $213.80 | $281.84 | $338.84 |
Where Maryland sits
The same service costs 4.9 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· 44th of 51
$407
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.