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 $416.87 Median $489.78 Typical High $630.96 | Professional | None | $416.87 | $489.78 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $426.58 | Professional | None | $363.08 | $407.38 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,019.95 Typical High $5,011.87 | Facility | None | $630.96 | $3,019.95 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $1,174.90 | Professional | None | $389.05 | $562.34 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,096.48 | Professional | None | $645.65 | $741.31 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $407.38 Median $676.08 Typical High $1,202.26 | Professional | None | $407.38 | $676.08 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,000.00 | Professional | None | $457.09 | $457.09 | $1,000.00 |
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 $208.93 Median $245.47 Typical High $316.23 | Professional | 52 · Reduced service | $208.93 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $97.72 Typical High $125.89 | Professional | 53 · Discontinued | $83.18 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $467.74 | Professional | 54 · Surgery only | $309.03 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $72.44 Typical High $93.33 | Professional | 55 · Aftercare only | $61.66 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $63.10 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $338.84 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $288.40 | $338.84 | $436.52 |
Where Maryland sits
The same service costs 4.2 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· 32nd 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.