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 $602.56 Median $812.83 Typical High $870.96 | Professional | None | $602.56 | $812.83 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,630.78 Typical High $6,025.60 | Facility | None | $446.68 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,288.25 | Professional | None | $562.34 | $758.58 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,584.89 | Professional | None | $912.01 | $1,047.13 | $1,584.89 |
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 $478.63 Median $691.83 Typical High $1,584.89 | Professional | None | $478.63 | $691.83 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,445.44 | Professional | None | $724.44 | $724.44 | $1,445.44 |
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 $302.00 Median $346.74 Typical High $436.52 | Professional | 52 · Reduced service | $302.00 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $120.23 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $660.69 | Professional | 54 · Surgery only | $457.09 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $616.60 |
Where Maryland sits
The same service costs 5.2 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· 45th of 51
$724
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.