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 $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $2,290.87 | Facility | None | $512.86 | $1,288.25 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,513.56 | Professional | None | $724.44 | $851.14 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,778.28 | Professional | None | $831.76 | $933.25 | $1,778.28 |
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 $676.08 Median $891.25 Typical High $1,949.84 | Professional | None | $676.08 | $891.25 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,288.25 | Professional | None | $691.83 | $691.83 | $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 $436.52 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $630.96 |
Where Maryland sits
The same service costs 6.9 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· 39th of 51
$912
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.