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 $257.04 Median $380.19 Typical High $436.52 | Professional | None | $257.04 | $380.19 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | None | $269.15 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,659.59 Typical High $2,691.53 | Facility | None | $331.13 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $630.96 | Professional | None | $245.47 | $389.05 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $776.25 | Professional | None | $436.52 | $501.19 | $776.25 |
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 $204.17 Median $331.13 Typical High $776.25 | Professional | None | $204.17 | $331.13 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $676.08 | Professional | None | $257.04 | $257.04 | $676.08 |
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 $128.82 Median $165.96 Typical High $218.78 | Professional | 52 · Reduced service | $128.82 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $52.48 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $251.19 Typical High $331.13 | Professional | 54 · Surgery only | $194.98 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $50.12 Typical High $66.07 | Professional | 55 · Aftercare only | $38.90 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.11 Typical High $43.65 | Professional | 56 · Pre-op care only | $25.70 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $234.42 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $181.97 | $234.42 | $309.03 |
Where Maryland sits
The same service costs 5.2 times more in Alaska than in Texas. 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
$324
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.