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 $741.31 Median $741.31 Typical High $758.58 | Professional | None | $741.31 | $741.31 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $831.76 | Professional | None | $616.60 | $676.08 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,079.46 Typical High $12,022.64 | Facility | None | $512.86 | $7,079.46 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,047.13 | Professional | None | $630.96 | $691.83 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,000.00 | Professional | None | $630.96 | $691.83 | $1,000.00 |
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 $630.96 Typical High $1,230.27 | Professional | None | $549.54 | $630.96 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $851.14 | Professional | None | $575.44 | $575.44 | $851.14 |
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 $371.54 Median $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 53 · Discontinued | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $537.03 |
Where Maryland sits
The same service costs 5.8 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
$676
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.