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 $794.33 Median $794.33 Typical High $851.14 | Professional | None | $794.33 | $794.33 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | None | $616.60 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,238.72 Typical High $3,630.78 | Facility | None | $630.96 | $2,238.72 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $758.58 | Professional | None | $588.84 | $616.60 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $912.01 | Professional | None | $602.56 | $660.69 | $912.01 |
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 $457.09 Median $588.84 Typical High $1,288.25 | Professional | None | $457.09 | $588.84 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $933.25 | Professional | None | $524.81 | $524.81 | $933.25 |
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 $398.11 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $588.84 |
Where Maryland sits
The same service costs 8.3 times more in Wyoming 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· 40th of 51
$692
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.