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 $741.31 Median $741.31 Typical High $776.25 | Professional | None | $741.31 | $741.31 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | None | $741.31 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,128.61 Typical High $8,511.38 | Facility | None | $630.96 | $5,128.61 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,318.26 | Professional | None | $660.69 | $741.31 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,318.26 | Professional | None | $707.95 | $812.83 | $1,318.26 |
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 $575.44 Median $691.83 Typical High $1,584.89 | Professional | None | $575.44 | $691.83 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,096.48 | Professional | None | $707.95 | $707.95 | $1,096.48 |
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 $363.08 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $363.08 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 53 · Discontinued | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $575.44 | Professional | 54 · Surgery only | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $537.03 |
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
$776
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.