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 $676.08 Median $831.76 Typical High $870.96 | Professional | None | $676.08 | $831.76 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | None | $630.96 | $707.95 | $707.95 |
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 $645.65 Median $794.33 Typical High $1,202.26 | Professional | None | $645.65 | $794.33 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,737.80 | Professional | None | $933.25 | $1,047.13 | $1,737.80 |
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 $562.34 Median $794.33 Typical High $1,698.24 | Professional | None | $562.34 | $794.33 | $1,698.24 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,445.44 | Professional | None | $660.69 | $660.69 | $1,445.44 |
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 $338.84 Median $338.84 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $134.90 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $512.86 Typical High $645.65 | Professional | 54 · Surgery only | $501.19 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $87.10 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $478.63 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $467.74 | $478.63 | $602.56 |
Where Maryland sits
The same service costs 4.4 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· 38th of 51
$794
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.