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 $602.56 Median $602.56 Typical High $630.96 | Professional | None | $602.56 | $602.56 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | None | $467.74 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,778.28 Typical High $3,162.28 | Facility | None | $707.95 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $616.60 | Professional | None | $446.68 | $467.74 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $707.95 | Professional | None | $446.68 | $489.78 | $707.95 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $912.01 | Professional | None | $363.08 | $467.74 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $691.83 | Professional | None | $398.11 | $398.11 | $691.83 |
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 $302.00 Median $302.00 Typical High $316.23 | Professional | 52 · Reduced service | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 53 · Discontinued | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $478.63 | Professional | 54 · Surgery only | $446.68 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $446.68 |
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· 43rd 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.