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 $660.69 Median $724.44 Typical High $741.31 | Professional | None | $660.69 | $724.44 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $891.25 | Professional | None | $691.83 | $776.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,090.30 Typical High $5,248.07 | Facility | None | $512.86 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,819.70 | Professional | None | $676.08 | $812.83 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,230.27 | Professional | None | $707.95 | $812.83 | $1,230.27 |
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 $616.60 Median $933.25 Typical High $1,778.28 | Professional | None | $616.60 | $933.25 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,071.52 | Professional | None | $562.34 | $562.34 | $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 $331.13 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $512.86 |
Where Maryland sits
The same service costs 6.2 times more in Wisconsin 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· 38th 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.