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 $524.81 Median $537.03 Typical High $602.56 | Professional | None | $524.81 | $537.03 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | None | $426.58 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,122.02 Typical High $2,089.30 | Facility | None | $512.86 | $1,122.02 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $707.95 | Professional | None | $416.87 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $660.69 | Professional | None | $407.38 | $457.09 | $660.69 |
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 $416.87 Median $524.81 Typical High $1,071.52 | Professional | None | $416.87 | $524.81 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $630.96 | Professional | None | $407.38 | $407.38 | $630.96 |
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 $269.15 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $407.38 |
Where Maryland sits
The same service costs 8.1 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· 44th of 51
$525
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.