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 Facility Modifier None Typical Low $707.95 Median $776.25 Typical High $977.24 | Facility | None | $707.95 | $776.25 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $794.33 | Professional | None | $562.34 | $707.95 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $616.60 | Professional | None | $537.03 | $602.56 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $2,137.96 | Facility | None | $512.86 | $1,148.15 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,023.29 | Professional | None | $537.03 | $676.08 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,445.44 | Professional | None | $758.58 | $851.14 | $1,445.44 |
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 $489.78 Median $660.69 Typical High $1,380.38 | Professional | None | $489.78 | $660.69 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,174.90 | Professional | None | $549.54 | $549.54 | $1,174.90 |
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 $281.84 Median $288.40 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $436.52 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $407.38 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $398.11 | $407.38 | $512.86 |
Where Maryland sits
The same service costs 4.3 times more in Alaska than in Texas. 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
$631
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.