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 $501.19 Median $501.19 Typical High $562.34 | Professional | None | $501.19 | $501.19 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $691.83 | Professional | None | $575.44 | $645.65 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,344.23 Typical High $3,801.89 | Facility | None | $707.95 | $2,344.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,513.56 | Professional | None | $537.03 | $660.69 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,023.29 | Professional | None | $549.54 | $630.96 | $1,023.29 |
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 $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 $537.03 Median $537.03 Typical High $831.76 | Professional | None | $537.03 | $537.03 | $831.76 |
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 $251.19 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $426.58 | Professional | 54 · Surgery only | $371.54 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $85.11 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $398.11 |
Where Maryland sits
The same service costs 6.9 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· 39th of 51
$724
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.