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 $263.03 Median $398.11 Typical High $436.52 | Professional | None | $263.03 | $398.11 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | None | $275.42 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $1,659.59 | Facility | None | $446.68 | $891.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $616.60 | Professional | None | $251.19 | $389.05 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $758.58 | Professional | None | $436.52 | $501.19 | $758.58 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,754.23 | Facility | None | $758.58 | $1,412.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $758.58 | Professional | None | $213.80 | $338.84 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $676.08 | Professional | None | $354.81 | $354.81 | $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 $131.83 Median $169.82 Typical High $218.78 | Professional | 52 · Reduced service | $131.83 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $67.61 Typical High $87.10 | Professional | 53 · Discontinued | $52.48 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $39.81 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $33.88 Typical High $43.65 | Professional | 56 · Pre-op care only | $26.30 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $302.00 |
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· 41st of 51
$355
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.