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 $562.34 Median $602.56 Typical High $741.31 | Professional | None | $562.34 | $602.56 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | None | $436.52 | $489.78 | $489.78 |
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 $501.19 Typical High $660.69 | Professional | None | $416.87 | $501.19 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $933.25 | Professional | None | $575.44 | $645.65 | $933.25 |
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 $363.08 Median $467.74 Typical High $933.25 | Professional | None | $363.08 | $467.74 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $954.99 | Professional | None | $371.54 | $371.54 | $954.99 |
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 $281.84 Median $295.12 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $416.87 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $512.86 |
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· 42nd 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.