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 $380.19 Median $398.11 Typical High $426.58 | Professional | None | $380.19 | $398.11 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $15,488.17 Typical High $27,542.29 | Facility | None | $446.68 | $15,488.17 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $691.83 | Professional | None | $346.74 | $371.54 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $691.83 | Professional | None | $389.05 | $446.68 | $691.83 |
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 $316.23 Median $389.05 Typical High $812.83 | Professional | None | $316.23 | $389.05 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Professional | None | $398.11 | $398.11 | $602.56 |
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 $190.55 Median $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 53 · Discontinued | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $295.12 | Professional | 54 · Surgery only | $288.40 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $275.42 |
Where Maryland sits
The same service costs 5.6 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· 47th of 51
$398
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.