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 $891.25 Median $891.25 Typical High $933.25 | Professional | None | $891.25 | $891.25 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | None | $891.25 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,570.88 Typical High $7,585.78 | Facility | None | $630.96 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,621.81 | Professional | None | $776.25 | $891.25 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,621.81 | Professional | None | $912.01 | $1,023.29 | $1,621.81 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $3,890.45 | Facility | None | $954.99 | $2,089.30 | $3,890.45 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,819.70 | Professional | None | $630.96 | $812.83 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,380.38 | Professional | None | $776.25 | $776.25 | $1,380.38 |
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 $446.68 Median $446.68 Typical High $467.74 | Professional | 52 · Reduced service | $446.68 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | 53 · Discontinued | $177.83 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $660.69 |
Where Maryland sits
The same service costs 7.6 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
$912
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.