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 $346.74 Median $398.11 Typical High $831.76 | Professional | None | $346.74 | $398.11 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $426.58 | Professional | None | $371.54 | $407.38 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,778.28 Typical High $3,162.28 | Facility | None | $707.95 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $977.24 | Professional | None | $363.08 | $457.09 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $758.58 | Professional | None | $446.68 | $524.81 | $758.58 |
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 $338.84 Median $512.86 Typical High $1,000.00 | Professional | None | $338.84 | $512.86 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $691.83 | Professional | None | $512.86 | $630.96 | $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 $173.78 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $173.78 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $269.15 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $239.88 | $269.15 | $302.00 |
Where Maryland sits
The same service costs 3.8 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· 30th of 51
$513
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.