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 $338.84 Median $467.74 Typical High $537.03 | Professional | None | $338.84 | $467.74 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | None | $309.03 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,258.93 Typical High $2,041.74 | Facility | None | $331.13 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $1,000.00 | Professional | None | $331.13 | $501.19 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $870.96 | Professional | None | $426.58 | $575.44 | $870.96 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $933.25 | Professional | None | $309.03 | $524.81 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $776.25 | Professional | None | $398.11 | $398.11 | $776.25 |
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 $169.82 Median $186.21 Typical High $269.15 | Professional | 52 · Reduced service | $169.82 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $107.15 | Professional | 53 · Discontinued | $69.18 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $398.11 | Professional | 54 · Surgery only | $257.04 | $281.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $79.43 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $53.70 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $371.54 |
Where Maryland sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 35th of 51
$490
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.