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 $489.78 Median $645.65 Typical High $691.83 | Professional | None | $489.78 | $645.65 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | None | $489.78 | $549.54 | $549.54 |
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 $467.74 Median $616.60 Typical High $1,047.13 | Professional | None | $467.74 | $616.60 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,202.26 | Professional | None | $707.95 | $794.33 | $1,202.26 |
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 $371.54 Median $562.34 Typical High $1,288.25 | Professional | None | $371.54 | $562.34 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,096.48 | Professional | None | $602.56 | $602.56 | $1,096.48 |
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 $245.47 Median $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $245.47 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $138.04 | Professional | 53 · Discontinued | $97.72 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $512.86 | Professional | 54 · Surgery only | $363.08 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $69.18 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $389.05 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $338.84 | $389.05 | $478.63 |
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
$575
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.