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 $524.81 Median $660.69 Typical High $758.58 | Professional | None | $524.81 | $660.69 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | None | $537.03 | $588.84 | $588.84 |
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 $489.78 Median $660.69 Typical High $1,096.48 | Professional | None | $489.78 | $660.69 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,380.38 | Professional | None | $794.33 | $912.01 | $1,380.38 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $1,380.38 | Professional | None | $416.87 | $588.84 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,230.27 | Professional | None | $512.86 | $512.86 | $1,230.27 |
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 $263.03 Median $295.12 Typical High $380.19 | Professional | 52 · Reduced service | $263.03 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $151.36 | Professional | 53 · Discontinued | $104.71 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $562.34 | Professional | 54 · Surgery only | $398.11 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $60.26 Typical High $75.86 | Professional | 56 · Pre-op care only | $52.48 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $524.81 |
Where Maryland sits
The same service costs 5.0 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· 46th of 51
$589
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.