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 $616.60 Median $630.96 Typical High $660.69 | Professional | None | $616.60 | $630.96 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $2,691.53 | Facility | None | $512.86 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $1,122.02 | Professional | None | $537.03 | $616.60 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,148.15 | Professional | None | $645.65 | $724.44 | $1,148.15 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,258.93 | Professional | None | $446.68 | $575.44 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,000.00 | Professional | None | $549.54 | $549.54 | $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 $309.03 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $309.03 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $467.74 |
Where Maryland sits
The same service costs 6.8 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
$631
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.