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 $851.14 Median $851.14 Typical High $870.96 | Professional | None | $851.14 | $851.14 | $870.96 |
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 $512.86 Median $1,659.59 Typical High $2,691.53 | Facility | None | $512.86 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,513.56 | Professional | None | $724.44 | $831.76 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,513.56 | Professional | None | $794.33 | $912.01 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,862.09 | Professional | None | $691.83 | $831.76 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,202.26 | Professional | None | $812.83 | $812.83 | $1,202.26 |
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 $426.58 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $426.58 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | 54 · Surgery only | $630.96 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $616.60 |
Where Maryland sits
The same service costs 15.8 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· 42nd of 51
$891
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.