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 $575.44 Typical High $851.14 | Professional | None | $524.81 | $575.44 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | None | $524.81 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,630.78 Typical High $6,025.60 | Facility | None | $630.96 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,174.90 | Professional | None | $446.68 | $676.08 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,348.96 | Professional | None | $891.25 | $1,023.29 | $1,348.96 |
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 $363.08 Median $575.44 Typical High $1,202.26 | Professional | None | $363.08 | $575.44 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,412.54 | Professional | None | $645.65 | $645.65 | $1,412.54 |
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 $257.04 Median $288.40 Typical High $416.87 | Professional | 52 · Reduced service | $257.04 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $169.82 | Professional | 53 · Discontinued | $104.71 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $630.96 | Professional | 54 · Surgery only | $389.05 | $436.52 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $125.89 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $85.11 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $588.84 |
Where Maryland sits
The same service costs 5.0 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· 45th of 51
$617
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.