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 $933.25 Median $933.25 Typical High $1,000.00 | Professional | None | $933.25 | $933.25 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $933.25 | $1,047.13 | $1,047.13 |
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 $812.83 Median $933.25 Typical High $1,698.24 | Professional | None | $812.83 | $933.25 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,698.24 | Professional | None | $954.99 | $1,096.48 | $1,698.24 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,949.84 | Professional | None | $676.08 | $870.96 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,479.11 | Professional | None | $831.76 | $831.76 | $1,479.11 |
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 $467.74 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $186.21 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $707.95 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $691.83 |
Where Maryland sits
The same service costs 7.2 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
$955
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.