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 $645.65 Median $691.83 Typical High $794.33 | Professional | None | $645.65 | $691.83 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $707.95 | Professional | None | $616.60 | $676.08 | $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 $616.60 Median $741.31 Typical High $1,174.90 | Professional | None | $616.60 | $741.31 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,698.24 | Professional | None | $831.76 | $954.99 | $1,698.24 |
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 $562.34 Median $758.58 Typical High $1,621.81 | Professional | None | $562.34 | $758.58 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,288.25 | Professional | None | $645.65 | $645.65 | $1,288.25 |
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 $323.59 Median $331.13 Typical High $398.11 | Professional | 52 · Reduced service | $323.59 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $162.18 | Professional | 53 · Discontinued | $128.82 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $602.56 | Professional | 54 · Surgery only | $478.63 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $120.23 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $562.34 |
Where Maryland sits
The same service costs 4.5 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
$708
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.