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 $549.54 Median $562.34 Typical High $575.44 | Professional | None | $549.54 | $562.34 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,570.88 Typical High $7,585.78 | Facility | None | $512.86 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $1,000.00 | Professional | None | $489.78 | $549.54 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,000.00 | Professional | None | $602.56 | $676.08 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $1,174.90 | Professional | None | $436.52 | $524.81 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $912.01 | Professional | None | $537.03 | $537.03 | $912.01 |
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 $275.42 Median $275.42 Typical High $288.40 | Professional | 52 · Reduced service | $275.42 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 53 · Discontinued | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | 54 · Surgery only | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $398.11 |
Where Maryland sits
The same service costs 8.1 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· 41st of 51
$575
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.