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 $588.84 Typical High $588.84 | Professional | None | $537.03 | $588.84 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $660.69 | Professional | None | $575.44 | $645.65 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,479.11 | Professional | None | $562.34 | $691.83 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,000.00 | Professional | None | $549.54 | $630.96 | $1,000.00 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $1,412.54 | Professional | None | $501.19 | $741.31 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $831.76 | Professional | None | $446.68 | $446.68 | $831.76 |
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 $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $380.19 | $398.11 | $416.87 |
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· 42nd of 51
$617
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.