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 $660.69 Median $691.83 Typical High $741.31 | Professional | None | $660.69 | $691.83 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | None | $660.69 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,677.35 Typical High $7,762.47 | Facility | None | $512.86 | $4,677.35 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,174.90 | Professional | None | $588.84 | $660.69 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,174.90 | Professional | None | $660.69 | $741.31 | $1,174.90 |
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 $501.19 Median $630.96 Typical High $1,412.54 | Professional | None | $501.19 | $630.96 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,000.00 | Professional | None | $616.60 | $616.60 | $1,000.00 |
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 $331.13 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $131.83 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $489.78 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $489.78 |
Where Maryland sits
The same service costs 7.2 times more in Alaska than in Utah. 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
$692
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.