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 $467.74 Median $489.78 Typical High $562.34 | Professional | None | $467.74 | $489.78 | $562.34 |
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 $1,096.48 Typical High $1,949.84 | Facility | None | $446.68 | $1,096.48 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $501.19 | Professional | None | $346.74 | $389.05 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $707.95 | Professional | None | $446.68 | $512.86 | $707.95 |
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 $288.40 Median $363.08 Typical High $776.25 | Professional | None | $288.40 | $363.08 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $724.44 | Professional | None | $346.74 | $346.74 | $724.44 |
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 $234.42 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $323.59 | $346.74 | $398.11 |
Where Maryland sits
The same service costs 6.0 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
$427
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.