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 $724.44 Median $724.44 Typical High $758.58 | Professional | None | $724.44 | $724.44 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | None | $776.25 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $2,691.53 | Facility | None | $512.86 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,288.25 | Professional | None | $588.84 | $724.44 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,288.25 | Professional | None | $724.44 | $812.83 | $1,288.25 |
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 $660.69 Typical High $1,513.56 | Professional | None | $512.86 | $660.69 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,096.48 | Professional | None | $630.96 | $630.96 | $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 $380.19 | Professional | 52 · Reduced service | $363.08 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $524.81 |
Where Maryland sits
The same service costs 19.5 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· 39th 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.