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 $537.03 Median $575.44 Typical High $758.58 | Professional | None | $537.03 | $575.44 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | None | $426.58 | $467.74 | $467.74 |
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 $407.38 Median $512.86 Typical High $676.08 | Professional | None | $407.38 | $512.86 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $933.25 | Professional | None | $602.56 | $676.08 | $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 $354.81 Median $467.74 Typical High $912.01 | Professional | None | $354.81 | $467.74 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $977.24 | Professional | None | $457.09 | $457.09 | $977.24 |
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 $269.15 Median $288.40 Typical High $380.19 | Professional | 52 · Reduced service | $269.15 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $151.36 | Professional | 53 · Discontinued | $107.15 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $575.44 | Professional | 54 · Surgery only | $407.38 | $426.58 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $114.82 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $75.86 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $380.19 | $398.11 | $537.03 |
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· 45th 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.