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 $691.83 Median $691.83 Typical High $741.31 | Professional | None | $691.83 | $691.83 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | None | $707.95 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,630.78 Typical High $6,025.60 | Facility | None | $512.86 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,258.93 | Professional | None | $616.60 | $707.95 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,258.93 | Professional | None | $691.83 | $794.33 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,479.11 | Professional | None | $524.81 | $660.69 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,071.52 | Professional | None | $645.65 | $645.65 | $1,071.52 |
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 $346.74 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | 53 · Discontinued | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $524.81 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $512.86 |
Where Maryland sits
The same service costs 7.9 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· 40th of 51
$741
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.