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 $676.08 Median $676.08 Typical High $724.44 | Professional | None | $676.08 | $676.08 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | None | $537.03 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $2,290.87 | Facility | None | $512.86 | $1,288.25 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $691.83 | Professional | None | $512.86 | $524.81 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $794.33 | Professional | None | $512.86 | $562.34 | $794.33 |
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 $398.11 Median $501.19 Typical High $1,122.02 | Professional | None | $398.11 | $501.19 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $794.33 | Professional | None | $457.09 | $457.09 | $794.33 |
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 $338.84 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $512.86 |
Where Maryland sits
The same service costs 7.6 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· 43rd of 51
$589
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.