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 $758.58 Median $831.76 Typical High $912.01 | Professional | None | $758.58 | $831.76 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | None | $758.58 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,754.23 Typical High $4,677.35 | Facility | None | $446.68 | $2,754.23 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $2,089.30 | Professional | None | $776.25 | $891.25 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,412.54 | Professional | None | $741.31 | $851.14 | $1,412.54 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,995.26 | Professional | None | $691.83 | $1,047.13 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,122.02 | Professional | None | $645.65 | $645.65 | $1,122.02 |
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 $380.19 Median $398.11 Typical High $416.87 | Professional | 52 · Reduced service | $380.19 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $588.84 |
Where Maryland sits
The same service costs 6.6 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· 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.