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 $288.40 Median $389.05 Typical High $457.09 | Professional | None | $288.40 | $389.05 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | None | $309.03 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $3,019.95 | Facility | None | $630.96 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $676.08 | Professional | None | $281.84 | $416.87 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $812.83 | Professional | None | $457.09 | $524.81 | $812.83 |
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 $245.47 Median $389.05 Typical High $812.83 | Professional | None | $245.47 | $389.05 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $707.95 | Professional | None | $288.40 | $288.40 | $707.95 |
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 $144.54 Median $181.97 Typical High $229.09 | Professional | 52 · Reduced service | $144.54 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $93.33 | Professional | 53 · Discontinued | $57.54 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $275.42 Typical High $346.74 | Professional | 54 · Surgery only | $218.78 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $54.95 Typical High $69.18 | Professional | 55 · Aftercare only | $43.65 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $37.15 Typical High $45.71 | Professional | 56 · Pre-op care only | $28.84 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $257.04 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $204.17 | $257.04 | $323.59 |
Where Maryland sits
The same service costs 5.6 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· 45th of 51
$372
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.