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 $457.09 Median $457.09 Typical High $478.63 | Professional | None | $457.09 | $457.09 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | None | $371.54 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $446.68 | Professional | None | $338.84 | $346.74 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $512.86 | Professional | None | $338.84 | $371.54 | $512.86 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $741.31 | Professional | None | $263.03 | $338.84 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $512.86 | Professional | None | $302.00 | $302.00 | $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 $223.87 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | 54 · Surgery only | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $338.84 |
Where Maryland sits
The same service costs 6.9 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· 38th 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.