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 $562.34 Median $575.44 Typical High $645.65 | Professional | None | $562.34 | $575.44 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $776.25 | Professional | None | $660.69 | $741.31 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,000.00 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,737.80 | Professional | None | $588.84 | $741.31 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,174.90 | Professional | None | $660.69 | $758.58 | $1,174.90 |
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 $562.34 Median $831.76 Typical High $1,621.81 | Professional | None | $562.34 | $831.76 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,000.00 | Professional | None | $575.44 | $575.44 | $1,000.00 |
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 $281.84 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $281.84 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $123.03 | Professional | 53 · Discontinued | $112.20 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $436.52 |
Where Maryland sits
The same service costs 6.2 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· 40th of 51
$794
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.