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 $630.96 Median $645.65 Typical High $645.65 | Professional | None | $630.96 | $645.65 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | None | $524.81 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,513.56 Typical High $2,398.83 | Facility | None | $446.68 | $1,513.56 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $954.99 | Professional | None | $501.19 | $588.84 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $1,096.48 | Professional | None | $524.81 | $575.44 | $1,096.48 |
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 $436.52 Median $562.34 Typical High $1,230.27 | Professional | None | $436.52 | $562.34 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $794.33 | Professional | None | $446.68 | $446.68 | $794.33 |
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 $316.23 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $316.23 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $457.09 |
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· 47th 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.