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 $537.03 Median $562.34 Typical High $741.31 | Professional | None | $537.03 | $562.34 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | None | $537.03 | $602.56 | $602.56 |
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 $478.63 Median $537.03 Typical High $977.24 | Professional | None | $478.63 | $537.03 | $977.24 |
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 $4,168.69 | Facility | None | $954.99 | $2,089.30 | $4,168.69 |
United Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,148.15 | Professional | None | $416.87 | $512.86 | $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 $269.15 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | 54 · Surgery only | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $398.11 |
Where Maryland sits
The same service costs 6.3 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· 43rd 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.