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 $524.81 Typical High $562.34 | Professional | None | $524.81 | $524.81 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | None | $416.87 | $457.09 | $457.09 |
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 $389.05 Median $407.38 Typical High $562.34 | Professional | None | $389.05 | $407.38 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $630.96 | Professional | None | $398.11 | $436.52 | $630.96 |
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 $309.03 Median $407.38 Typical High $851.14 | Professional | None | $309.03 | $407.38 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $616.60 | Professional | None | $346.74 | $346.74 | $616.60 |
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 $263.03 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $104.71 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $389.05 |
Where Maryland sits
The same service costs 7.9 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· 42nd of 51
$457
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.