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 $398.11 Median $457.09 Typical High $660.69 | Professional | None | $398.11 | $457.09 | $660.69 |
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 $1,659.59 Typical High $2,691.53 | Facility | None | $512.86 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $954.99 | Professional | None | $354.81 | $389.05 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $758.58 | Professional | None | $363.08 | $416.87 | $758.58 |
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 $338.84 Median $478.63 Typical High $1,023.29 | Professional | None | $338.84 | $478.63 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $549.54 | Professional | None | $309.03 | $309.03 | $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 $208.93 Median $229.09 Typical High $234.42 | Professional | 52 · Reduced service | $208.93 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $91.20 Typical High $93.33 | Professional | 53 · Discontinued | $85.11 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $45.71 Typical High $46.77 | Professional | 56 · Pre-op care only | $42.66 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $323.59 |
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· 41st of 51
$550
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.