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 $562.34 Median $562.34 Typical High $588.84 | Professional | None | $562.34 | $562.34 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | None | $562.34 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $3,019.95 | Facility | None | $630.96 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $1,000.00 | Professional | None | $489.78 | $562.34 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,000.00 | Professional | None | $562.34 | $645.65 | $1,000.00 |
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 $389.05 Median $524.81 Typical High $1,202.26 | Professional | None | $389.05 | $524.81 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $870.96 | Professional | None | $489.78 | $489.78 | $870.96 |
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 $281.84 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $416.87 |
Where Maryland sits
The same service costs 7.4 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
$589
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.