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 $676.08 Typical High $776.25 | Professional | None | $660.69 | $676.08 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | None | $776.25 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,311.31 Typical High $5,248.07 | Facility | None | $707.95 | $3,311.31 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $2,041.74 | Professional | None | $724.44 | $851.14 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,380.38 | Professional | None | $741.31 | $851.14 | $1,380.38 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,949.84 | Professional | None | $691.83 | $1,023.29 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,122.02 | Professional | None | $741.31 | $741.31 | $1,122.02 |
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 $380.19 | Professional | 52 · Reduced service | $331.13 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $512.86 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $478.63 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $478.63 | $537.03 |
Where Maryland sits
The same service costs 6.8 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
$871
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.