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 $645.65 Median $691.83 Typical High $707.95 | Professional | None | $645.65 | $691.83 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $812.83 | Professional | None | $602.56 | $660.69 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $2,344.23 | Facility | None | $446.68 | $1,479.11 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $933.25 | Professional | None | $549.54 | $616.60 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $954.99 | Professional | None | $602.56 | $660.69 | $954.99 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $1,096.48 | Professional | None | $436.52 | $562.34 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $812.83 | Professional | None | $478.63 | $478.63 | $812.83 |
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 $338.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $501.19 |
Where Maryland sits
The same service costs 5.6 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· 35th of 51
$646
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.