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 $489.78 Median $1,380.38 Typical High $7,585.78 | Professional | None | $489.78 | $1,380.38 | $7,585.78 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $562.34 | Professional | None | $407.38 | $457.09 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,413.10 Typical High $12,589.25 | Facility | None | $512.86 | $7,413.10 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,023.29 Typical High $8,317.64 | Professional | None | $436.52 | $1,023.29 | $8,317.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,332.54 | Professional | None | $5,128.61 | $6,760.83 | $9,332.54 |
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 $407.38 Median $4,897.79 Typical High $10,471.29 | Professional | None | $407.38 | $4,897.79 | $10,471.29 |
Wellpoint Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $7,943.28 | Professional | None | $5,888.44 | $5,888.44 | $7,943.28 |
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 $245.47 Median $2,511.89 Typical High $3,801.89 | Professional | 52 · Reduced service | $245.47 | $2,511.89 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $1,023.29 Typical High $1,513.56 | Professional | 53 · Discontinued | $97.72 | $1,023.29 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $3,801.89 Typical High $5,623.41 | Professional | 54 · Surgery only | $371.54 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $758.58 Typical High $1,122.02 | Professional | 55 · Aftercare only | $74.13 | $758.58 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $512.86 Typical High $758.58 | Professional | 56 · Pre-op care only | $48.98 | $512.86 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $3,548.13 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $346.74 | $3,548.13 | $5,248.07 |
Where Maryland sits
The same service costs 17.8 times more in Iowa than in Washington, DC. 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· 50th of 51
$603
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.