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 $933.25 Typical High $1,513.56 | Professional | None | $724.44 | $933.25 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | None | $588.84 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,951.21 Typical High $5,011.87 | Facility | None | $446.68 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,778.28 | Professional | None | $645.65 | $912.01 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,548.82 | Professional | None | $933.25 | $1,071.52 | $1,548.82 |
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 $588.84 Median $954.99 Typical High $1,819.70 | Professional | None | $588.84 | $954.99 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,445.44 | Professional | None | $501.19 | $501.19 | $1,445.44 |
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 $371.54 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $371.54 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $776.25 | Professional | 54 · Surgery only | $537.03 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $158.49 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $724.44 |
Where Maryland sits
The same service costs 5.0 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· 36th of 51
$933
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.