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 $489.78 Median $602.56 Typical High $645.65 | Professional | None | $489.78 | $602.56 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | None | $501.19 | $549.54 | $549.54 |
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 $467.74 Median $575.44 Typical High $1,000.00 | Professional | None | $467.74 | $575.44 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,202.26 | Professional | None | $691.83 | $794.33 | $1,202.26 |
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 $389.05 Median $537.03 Typical High $1,230.27 | Professional | None | $389.05 | $537.03 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,071.52 | Professional | None | $457.09 | $457.09 | $1,071.52 |
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 $245.47 Median $269.15 Typical High $323.59 | Professional | 52 · Reduced service | $245.47 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $371.54 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $446.68 |
Where Maryland sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 47th of 51
$550
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.