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 $588.84 Median $645.65 Typical High $758.58 | Professional | None | $588.84 | $645.65 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | None | $512.86 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $1,202.26 | Facility | None | $446.68 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,174.90 | Professional | None | $562.34 | $676.08 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,318.26 | Professional | None | $758.58 | $870.96 | $1,318.26 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,445.44 | Professional | None | $446.68 | $588.84 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,202.26 | Professional | None | $602.56 | $602.56 | $1,202.26 |
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 $295.12 Median $323.59 Typical High $380.19 | Professional | 52 · Reduced service | $295.12 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $436.52 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $537.03 |
Where Maryland sits
The same service costs 5.6 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· 44th of 51
$617
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.