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 $323.59 | Professional | None | $316.23 | $316.23 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | None | $323.59 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $13,489.63 Typical High $24,547.09 | Facility | None | $331.13 | $13,489.63 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $575.44 | Professional | None | $275.42 | $295.12 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $562.34 | Professional | None | $331.13 | $380.19 | $562.34 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,413.10 Typical High $33,884.42 | Facility | None | $3,019.95 | $7,413.10 | $33,884.42 |
United Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $645.65 | Professional | None | $229.09 | $295.12 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $512.86 | Professional | None | $281.84 | $281.84 | $512.86 |
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 $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $63.10 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $245.47 | Professional | 54 · Surgery only | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $229.09 |
Where Maryland sits
The same service costs 5.8 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· 43rd of 51
$324
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.