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 $524.81 Median $602.56 Typical High $660.69 | Professional | None | $524.81 | $602.56 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | None | $524.81 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,187.76 Typical High $3,890.45 | Facility | None | $954.99 | $2,187.76 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,122.02 | Professional | None | $512.86 | $630.96 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,174.90 | Professional | None | $691.83 | $794.33 | $1,174.90 |
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 $501.19 Median $645.65 Typical High $1,412.54 | Professional | None | $501.19 | $645.65 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,071.52 | Professional | None | $512.86 | $512.86 | $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 $263.03 Median $295.12 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $104.71 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $389.05 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $467.74 |
Where Maryland sits
The same service costs 6.2 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· 47th of 51
$603
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.