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 $436.52 Median $436.52 Typical High $457.09 | Professional | None | $436.52 | $436.52 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | None | $426.58 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $15,488.17 Typical High $28,183.83 | Facility | None | $446.68 | $15,488.17 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $812.83 | Professional | None | $316.23 | $416.87 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $831.76 | Professional | None | $501.19 | $549.54 | $831.76 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $13,803.84 Typical High $19,054.61 | Facility | None | $7,585.78 | $13,803.84 | $19,054.61 |
United Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $891.25 | Professional | None | $302.00 | $416.87 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $758.58 | Professional | None | $371.54 | $371.54 | $758.58 |
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 $218.78 Median $218.78 Typical High $229.09 | Professional | 52 · Reduced service | $218.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | 53 · Discontinued | $89.13 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 54 · Surgery only | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $323.59 |
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· 41st 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.