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 $691.83 Median $724.44 Typical High $741.31 | Professional | None | $691.83 | $724.44 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $812.83 | Professional | None | $588.84 | $660.69 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $5,011.87 | Facility | None | $512.86 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $954.99 | Professional | None | $562.34 | $660.69 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $954.99 | Professional | None | $562.34 | $616.60 | $954.99 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $1,148.15 | Professional | None | $489.78 | $588.84 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $758.58 | Professional | None | $501.19 | $501.19 | $758.58 |
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 $354.81 Median $354.81 Typical High $371.54 | Professional | 52 · Reduced service | $354.81 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $524.81 |
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· 41st of 51
$661
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.