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 $676.08 Median $707.95 Typical High $724.44 | Professional | None | $676.08 | $707.95 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | None | $676.08 | $758.58 | $758.58 |
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 $602.56 Median $676.08 Typical High $1,202.26 | Professional | None | $602.56 | $676.08 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,202.26 | Professional | None | $676.08 | $758.58 | $1,202.26 |
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 $512.86 Median $645.65 Typical High $1,445.44 | Professional | None | $512.86 | $645.65 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Professional | None | $645.65 | $645.65 | $1,023.29 |
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 $338.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $501.19 |
Where Maryland sits
The same service costs 7.2 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· 41st of 51
$708
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.