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 $812.83 Median $812.83 Typical High $851.14 | Professional | None | $812.83 | $812.83 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | None | $812.83 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $3,019.95 | Facility | None | $630.96 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,479.11 | Professional | None | $724.44 | $812.83 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,445.44 | Professional | None | $794.33 | $912.01 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,073.80 Typical High $7,079.46 | Facility | None | $1,621.81 | $4,073.80 | $7,079.46 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,737.80 | Professional | None | $616.60 | $776.25 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,230.27 | Professional | None | $758.58 | $758.58 | $1,230.27 |
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 $407.38 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $588.84 |
Where Maryland sits
The same service costs 6.9 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
$851
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.