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 $524.81 Median $524.81 Typical High $562.34 | Professional | None | $524.81 | $524.81 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | None | $524.81 | $588.84 | $588.84 |
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 $467.74 Median $524.81 Typical High $954.99 | Professional | None | $467.74 | $524.81 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $954.99 | Professional | None | $537.03 | $602.56 | $954.99 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $3,890.45 | Facility | None | $954.99 | $2,089.30 | $3,890.45 |
United Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $1,148.15 | Professional | None | $407.38 | $501.19 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $812.83 | Professional | None | $512.86 | $512.86 | $812.83 |
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 $263.03 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $104.71 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $389.05 |
Where Maryland sits
The same service costs 5.9 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· 40th of 51
$562
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.