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 $501.19 Median $501.19 Typical High $512.86 | Professional | None | $501.19 | $501.19 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $537.03 | Professional | None | $457.09 | $512.86 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $3,162.28 | Facility | None | $630.96 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $1,445.44 | Professional | None | $457.09 | $562.34 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $812.83 | Professional | None | $457.09 | $524.81 | $812.83 |
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 $416.87 Median $616.60 Typical High $1,148.15 | Professional | None | $416.87 | $616.60 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $691.83 | Professional | None | $371.54 | $371.54 | $691.83 |
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 $251.19 Median $251.19 Typical High $257.04 | Professional | 52 · Reduced service | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $100.00 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $363.08 |
Where Maryland sits
The same service costs 5.4 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
$603
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.