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 $575.44 Median $575.44 Typical High $616.60 | Professional | None | $575.44 | $575.44 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | None | $588.84 | $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 $512.86 Median $588.84 Typical High $1,047.13 | Professional | None | $512.86 | $588.84 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,047.13 | Professional | None | $588.84 | $660.69 | $1,047.13 |
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 $416.87 Median $549.54 Typical High $1,230.27 | Professional | None | $416.87 | $549.54 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $891.25 | Professional | None | $512.86 | $512.86 | $891.25 |
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 $288.40 Median $288.40 Typical High $302.00 | Professional | 52 · Reduced service | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $117.49 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $436.52 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $426.58 |
Where Maryland sits
The same service costs 7.8 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· 42nd of 51
$603
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.