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 $524.81 Median $549.54 Typical High $691.83 | Professional | None | $524.81 | $549.54 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $588.84 | Professional | None | $436.52 | $478.63 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,019.95 Typical High $5,011.87 | Facility | None | $630.96 | $3,019.95 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $812.83 | Professional | None | $457.09 | $575.44 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $912.01 | Professional | None | $537.03 | $645.65 | $912.01 |
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 $398.11 Median $501.19 Typical High $954.99 | Professional | None | $398.11 | $501.19 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $776.25 | Professional | None | $363.08 | $363.08 | $776.25 |
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 $263.03 Median $275.42 Typical High $346.74 | Professional | 52 · Reduced service | $263.03 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $138.04 | Professional | 53 · Discontinued | $104.71 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $69.18 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $489.78 |
Where Maryland sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$525
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.