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 $660.69 Median $831.76 Typical High $912.01 | Professional | None | $660.69 | $831.76 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | None | $676.08 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $891.25 Typical High $1,584.89 | Facility | None | $331.13 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,479.11 | Professional | None | $660.69 | $851.14 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,148.15 | $1,737.80 |
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 $562.34 Median $812.83 Typical High $1,995.26 | Professional | None | $562.34 | $812.83 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,584.89 | Professional | None | $691.83 | $691.83 | $1,584.89 |
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 $331.13 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $331.13 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $162.18 Typical High $181.97 | Professional | 53 · Discontinued | $131.83 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $501.19 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $66.07 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $467.74 | $575.44 | $645.65 |
Where Maryland sits
The same service costs 4.8 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· 47th of 51
$759
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.