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 $588.84 Median $588.84 Typical High $616.60 | Professional | None | $588.84 | $588.84 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | None | $588.84 | $660.69 | $660.69 |
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 $524.81 Median $602.56 Typical High $1,071.52 | Professional | None | $524.81 | $602.56 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,071.52 | Professional | None | $575.44 | $645.65 | $1,071.52 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $1,318.26 | Professional | None | $489.78 | $588.84 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Professional | None | $575.44 | $575.44 | $870.96 |
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 $295.12 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $295.12 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $117.49 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $436.52 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $436.52 |
Where Maryland sits
The same service costs 8.5 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
$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.