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 $446.68 Median $467.74 Typical High $478.63 | Professional | None | $446.68 | $467.74 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | None | $354.81 | $398.11 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,691.53 Typical High $4,677.35 | Facility | None | $512.86 | $2,691.53 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $977.24 | Professional | None | $363.08 | $436.52 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $758.58 | Professional | None | $354.81 | $407.38 | $758.58 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $5,623.41 | Facility | None | $954.99 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $1,047.13 | Professional | None | $338.84 | $501.19 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $549.54 | Professional | None | $316.23 | $316.23 | $549.54 |
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 $218.78 Median $234.42 Typical High $239.88 | Professional | 52 · Reduced service | $218.78 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $95.50 | Professional | 53 · Discontinued | $89.13 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $354.81 | Professional | 54 · Surgery only | $331.13 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $70.79 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $47.86 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $331.13 |
Where Maryland sits
The same service costs 4.9 times more in Alaska than in Ohio. 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· 39th 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.