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 $331.13 Median $478.63 Typical High $562.34 | Professional | None | $331.13 | $478.63 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | None | $354.81 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $2,691.53 | Facility | None | $512.86 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $812.83 | Professional | None | $309.03 | $489.78 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,047.13 | Professional | None | $630.96 | $707.95 | $1,047.13 |
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 $257.04 Median $416.87 Typical High $933.25 | Professional | None | $257.04 | $416.87 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $977.24 | Professional | None | $436.52 | $436.52 | $977.24 |
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 $165.96 Median $208.93 Typical High $281.84 | Professional | 52 · Reduced service | $165.96 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $112.20 | Professional | 53 · Discontinued | $66.07 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $426.58 | Professional | 54 · Surgery only | $251.19 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $85.11 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $398.11 |
Where Maryland sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$437
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.