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 $645.65 Median $676.08 Typical High $676.08 | Professional | None | $645.65 | $676.08 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | None | $691.83 | $758.58 | $758.58 |
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 $562.34 Median $630.96 Typical High $1,174.90 | Professional | None | $562.34 | $630.96 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,148.15 | Professional | None | $630.96 | $724.44 | $1,148.15 |
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 $512.86 Median $616.60 Typical High $1,412.54 | Professional | None | $512.86 | $616.60 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $954.99 | Professional | None | $630.96 | $630.96 | $954.99 |
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 $323.59 Median $323.59 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | 54 · Surgery only | $478.63 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $467.74 |
Where Maryland sits
The same service costs 7.1 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· 41st of 51
$692
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.