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 Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $691.83 | Facility | None | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $549.54 | Professional | None | $501.19 | $524.81 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | None | $501.19 | $549.54 | $549.54 |
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 $501.19 Median $602.56 Typical High $1,380.38 | Professional | None | $501.19 | $602.56 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $933.25 | Professional | None | $549.54 | $630.96 | $933.25 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,288.25 | Professional | None | $446.68 | $660.69 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $831.76 | Professional | None | $407.38 | $407.38 | $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 $251.19 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $100.00 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $380.19 |
Where Maryland sits
The same service costs 5.4 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
$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.