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 $707.95 Median $741.31 Typical High $758.58 | Professional | None | $707.95 | $741.31 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | None | $707.95 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,818.38 | Facility | None | $1,000.00 | $1,548.82 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,288.25 | Professional | None | $630.96 | $707.95 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,288.25 | Professional | None | $691.83 | $776.25 | $1,288.25 |
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 $562.34 Median $676.08 Typical High $1,548.82 | Professional | None | $562.34 | $676.08 | $1,548.82 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,047.13 | Professional | None | $691.83 | $691.83 | $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 $354.81 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $354.81 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | 53 · Discontinued | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $524.81 |
Where Maryland sits
The same service costs 8.9 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
$759
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.