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 $616.60 Median $616.60 Typical High $630.96 | Professional | None | $616.60 | $616.60 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $691.83 | Professional | None | $562.34 | $630.96 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $3,162.28 | Facility | None | $630.96 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,778.28 | Professional | None | $562.34 | $676.08 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,000.00 | Professional | None | $562.34 | $645.65 | $1,000.00 |
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 $512.86 Median $758.58 Typical High $1,445.44 | Professional | None | $512.86 | $758.58 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $851.14 | Professional | None | $457.09 | $457.09 | $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 $309.03 Median $309.03 Typical High $316.23 | Professional | 52 · Reduced service | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 53 · Discontinued | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $446.68 |
Where Maryland sits
The same service costs 5.2 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· 45th of 51
$692
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.