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 $776.25 Median $812.83 Typical High $933.25 | Professional | None | $776.25 | $812.83 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | None | $794.33 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,691.53 | Facility | None | $446.68 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,513.56 | Professional | None | $724.44 | $851.14 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,202.26 | $1,819.70 |
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 $602.56 Median $794.33 Typical High $1,862.09 | Professional | None | $602.56 | $794.33 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,659.59 | Professional | None | $707.95 | $707.95 | $1,659.59 |
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 $389.05 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $660.69 |
Where Maryland sits
The same service costs 5.2 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· 43rd of 51
$832
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.