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 $478.63 Typical High $549.54 | Professional | None | $354.81 | $478.63 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | None | $363.08 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $1,412.54 | Facility | None | $630.96 | $776.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $794.33 | Professional | None | $346.74 | $489.78 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $954.99 | Professional | None | $537.03 | $616.60 | $954.99 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $977.24 | Professional | None | $302.00 | $457.09 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $831.76 | Professional | None | $489.78 | $489.78 | $831.76 |
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 $218.78 Typical High $275.42 | Professional | 52 · Reduced service | $177.83 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $70.79 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $66.07 Typical High $81.28 | Professional | 55 · Aftercare only | $53.70 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $54.95 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $380.19 |
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· 46th of 51
$447
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.