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 $630.96 Median $630.96 Typical High $676.08 | Professional | None | $630.96 | $630.96 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | None | $630.96 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,659.59 Typical High $2,691.53 | Facility | None | $331.13 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,148.15 | Professional | None | $549.54 | $645.65 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,148.15 | Professional | None | $660.69 | $741.31 | $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 $1,288.25 | Professional | None | $446.68 | $575.44 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,023.29 | Professional | None | $537.03 | $537.03 | $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 $316.23 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $316.23 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $478.63 |
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· 39th of 51
$646
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.