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 $457.09 Median $489.78 Typical High $501.19 | Professional | None | $457.09 | $489.78 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $446.68 | Professional | None | $380.19 | $416.87 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $3,801.89 | Facility | None | $512.86 | $2,137.96 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $1,023.29 | Professional | None | $380.19 | $457.09 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $794.33 | Professional | None | $371.54 | $426.58 | $794.33 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $1,122.02 | Professional | None | $363.08 | $537.03 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $575.44 | Professional | None | $338.84 | $338.84 | $575.44 |
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 $223.87 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $223.87 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $91.20 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $338.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $75.86 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $346.74 |
Where Maryland sits
The same service costs 5.5 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· 40th of 51
$603
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.