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 $616.60 Median $758.58 Typical High $870.96 | Professional | None | $616.60 | $758.58 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | None | $602.56 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,090.30 Typical High $5,011.87 | Facility | None | $707.95 | $3,090.30 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,288.25 | Professional | None | $575.44 | $741.31 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,445.44 | Professional | None | $851.14 | $954.99 | $1,445.44 |
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 $501.19 Median $707.95 Typical High $1,584.89 | Professional | None | $501.19 | $707.95 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,318.26 | Professional | None | $588.84 | $588.84 | $1,318.26 |
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 $309.03 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $309.03 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $123.03 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $660.69 | Professional | 54 · Surgery only | $457.09 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $426.58 | $524.81 | $616.60 |
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
$676
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.