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 $346.74 Median $562.34 Typical High $660.69 | Professional | None | $346.74 | $562.34 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | None | $346.74 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,951.21 Typical High $5,011.87 | Facility | None | $446.68 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $1,023.29 | Professional | None | $346.74 | $588.84 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,174.90 | Professional | None | $676.08 | $758.58 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $1,174.90 | Professional | None | $309.03 | $562.34 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,047.13 | Professional | None | $645.65 | $645.65 | $1,047.13 |
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 $173.78 Median $263.03 Typical High $331.13 | Professional | 52 · Reduced service | $173.78 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $104.71 Typical High $131.83 | Professional | 53 · Discontinued | $69.18 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $389.05 Typical High $501.19 | Professional | 54 · Surgery only | $263.03 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $77.62 Typical High $100.00 | Professional | 55 · Aftercare only | $52.48 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $52.48 Typical High $66.07 | Professional | 56 · Pre-op care only | $34.67 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $363.08 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $245.47 | $363.08 | $467.74 |
Where Maryland sits
The same service costs 4.9 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· 40th of 51
$562
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.