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 $588.84 Median $616.60 Typical High $660.69 | Professional | None | $588.84 | $616.60 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | None | $489.78 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $616.60 | Facility | None | $275.42 | $338.84 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $676.08 | Professional | None | $446.68 | $478.63 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $870.96 | Professional | None | $512.86 | $602.56 | $870.96 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $977.24 | Professional | None | $457.09 | $524.81 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $851.14 | Professional | None | $426.58 | $426.58 | $851.14 |
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 $295.12 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $117.49 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $446.68 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $457.09 |
Where Maryland sits
The same service costs 6.2 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
$537
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.