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 $512.86 Median $549.54 Typical High $794.33 | Professional | None | $512.86 | $549.54 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | None | $398.11 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,122.02 Typical High $2,089.30 | Facility | None | $630.96 | $1,122.02 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $676.08 | Professional | None | $380.19 | $537.03 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,047.13 | Professional | None | $616.60 | $691.83 | $1,047.13 |
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 $478.63 Typical High $870.96 | Professional | None | $363.08 | $478.63 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $1,000.00 | Professional | None | $338.84 | $338.84 | $1,000.00 |
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 $257.04 Median $275.42 Typical High $398.11 | Professional | 52 · Reduced service | $257.04 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $158.49 | Professional | 53 · Discontinued | $102.33 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $602.56 | Professional | 54 · Surgery only | $380.19 | $407.38 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $120.23 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $79.43 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $562.34 |
Where Maryland sits
The same service costs 6.2 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· 44th 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.