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 $467.74 Median $467.74 Typical High $489.78 | Professional | None | $467.74 | $467.74 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $575.44 | Professional | None | $407.38 | $457.09 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $2,630.27 | Facility | None | $512.86 | $1,479.11 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $676.08 | Professional | None | $398.11 | $436.52 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $660.69 | Professional | None | $416.87 | $467.74 | $660.69 |
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 $316.23 Median $407.38 Typical High $794.33 | Professional | None | $316.23 | $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 $234.42 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $354.81 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $346.74 |
Where Maryland sits
The same service costs 5.2 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· 37th of 51
$457
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.