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 $660.69 Median $707.95 Typical High $741.31 | Professional | None | $660.69 | $707.95 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $776.25 | Professional | None | $630.96 | $691.83 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,818.38 | Facility | None | $512.86 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,949.84 | Professional | None | $630.96 | $758.58 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,122.02 | Professional | None | $616.60 | $707.95 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,698.24 | Professional | None | $575.44 | $851.14 | $1,698.24 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $933.25 | Professional | None | $512.86 | $512.86 | $933.25 |
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 $331.13 Median $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $331.13 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $478.63 | $512.86 |
Where Maryland sits
The same service costs 5.8 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
$776
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.