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 $724.44 Median $812.83 Typical High $831.76 | Professional | None | $724.44 | $812.83 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $741.31 | Professional | None | $645.65 | $724.44 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,981.07 Typical High $6,606.93 | Facility | None | $512.86 | $3,981.07 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,698.24 | Professional | None | $630.96 | $758.58 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,348.96 | Professional | None | $660.69 | $758.58 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,862.09 | Professional | None | $549.54 | $776.25 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,023.29 | Professional | None | $512.86 | $512.86 | $1,023.29 |
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 $363.08 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $588.84 |
Where Maryland sits
The same service costs 6.0 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· 41st of 51
$891
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.