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 $426.58 Median $575.44 Typical High $676.08 | Professional | None | $426.58 | $575.44 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | None | $436.52 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,258.93 Typical High $2,187.76 | Facility | None | $446.68 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $954.99 | Professional | None | $389.05 | $588.84 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,258.93 | Professional | None | $724.44 | $831.76 | $1,258.93 |
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 $316.23 Median $524.81 Typical High $1,148.15 | Professional | None | $316.23 | $524.81 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,148.15 | Professional | None | $549.54 | $549.54 | $1,148.15 |
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 $213.80 Median $263.03 Typical High $338.84 | Professional | 52 · Reduced service | $213.80 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $104.71 Typical High $134.90 | Professional | 53 · Discontinued | $85.11 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $389.05 Typical High $501.19 | Professional | 54 · Surgery only | $316.23 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $79.43 Typical High $100.00 | Professional | 55 · Aftercare only | $63.10 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $52.48 Typical High $67.61 | Professional | 56 · Pre-op care only | $42.66 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $363.08 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $295.12 | $363.08 | $467.74 |
Where Maryland sits
The same service costs 4.8 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· 45th of 51
$525
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.