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 $602.56 Typical High $630.96 | Professional | None | $602.56 | $602.56 | $630.96 |
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 $630.96 Median $9,332.54 Typical High $15,848.93 | Facility | None | $630.96 | $9,332.54 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $1,096.48 | Professional | None | $549.54 | $616.60 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,096.48 | Professional | None | $602.56 | $691.83 | $1,096.48 |
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 $501.19 Median $588.84 Typical High $1,318.26 | Professional | None | $501.19 | $588.84 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $933.25 | Professional | None | $616.60 | $616.60 | $933.25 |
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 $302.00 Typical High $316.23 | Professional | 52 · Reduced service | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | 53 · Discontinued | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $478.63 | Professional | 54 · Surgery only | $457.09 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $446.68 |
Where Maryland sits
The same service costs 7.2 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· 43rd of 51
$631
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.