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 $354.81 Median $467.74 Typical High $645.65 | Professional | None | $354.81 | $467.74 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,202.26 Typical High $2,137.96 | Facility | None | $446.68 | $1,202.26 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $891.25 | Professional | None | $316.23 | $537.03 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,174.90 | Professional | None | $676.08 | $776.25 | $1,174.90 |
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 $251.19 Median $416.87 Typical High $1,047.13 | Professional | None | $251.19 | $416.87 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,071.52 | Professional | None | $457.09 | $457.09 | $1,071.52 |
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 $177.83 Median $208.93 Typical High $316.23 | Professional | 52 · Reduced service | $177.83 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $83.18 Typical High $128.82 | Professional | 53 · Discontinued | $70.79 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $316.23 Typical High $478.63 | Professional | 54 · Surgery only | $269.15 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $95.50 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $41.69 Typical High $64.57 | Professional | 56 · Pre-op care only | $35.48 | $41.69 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $295.12 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $251.19 | $295.12 | $446.68 |
Where Maryland sits
The same service costs 4.7 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· 43rd of 51
$457
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.