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 $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | None | $363.08 | $407.38 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,019.95 Typical High $5,011.87 | Facility | None | $512.86 | $3,019.95 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $954.99 | Professional | None | $346.74 | $426.58 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $660.69 | Professional | None | $354.81 | $407.38 | $660.69 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $912.01 | Professional | None | $331.13 | $489.78 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $537.03 | Professional | None | $354.81 | $354.81 | $537.03 |
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 $154.88 Median $158.49 Typical High $181.97 | Professional | 52 · Reduced service | $154.88 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $63.10 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $269.15 | Professional | 54 · Surgery only | $234.42 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $223.87 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $218.78 | $223.87 | $251.19 |
Where Maryland sits
The same service costs 9.3 times more in Kansas 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· 39th of 51
$479
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.