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 $489.78 Median $489.78 Typical High $501.19 | Professional | None | $489.78 | $489.78 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $549.54 | Professional | None | $407.38 | $446.68 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $1,202.26 | Facility | None | $331.13 | $660.69 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $660.69 | Professional | None | $389.05 | $436.52 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $660.69 | Professional | None | $416.87 | $457.09 | $660.69 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $794.33 | Professional | None | $309.03 | $407.38 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $562.34 | Professional | None | $338.84 | $338.84 | $562.34 |
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 $245.47 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $363.08 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $354.81 |
Where Maryland sits
The same service costs 6.3 times more in Alaska than in Texas. 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· 34th of 51
$447
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.