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 $371.54 Median $467.74 Typical High $630.96 | Professional | None | $371.54 | $467.74 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | None | $295.12 | $331.13 | $331.13 |
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 $275.42 Median $398.11 Typical High $524.81 | Professional | None | $275.42 | $398.11 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $758.58 | Professional | None | $478.63 | $549.54 | $758.58 |
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 $208.93 Median $309.03 Typical High $645.65 | Professional | None | $208.93 | $309.03 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $794.33 | Professional | None | $363.08 | $363.08 | $794.33 |
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 $186.21 Median $199.53 Typical High $316.23 | Professional | 52 · Reduced service | $186.21 | $199.53 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $79.43 Typical High $125.89 | Professional | 53 · Discontinued | $74.13 | $79.43 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $478.63 | Professional | 54 · Surgery only | $281.84 | $302.00 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $95.50 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $63.10 | Professional | 56 · Pre-op care only | $37.15 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $281.84 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $263.03 | $281.84 | $446.68 |
Where Maryland sits
The same service costs 5.9 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
$398
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.