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 $194.98 Median $812.83 Typical High $891.25 | Professional | None | $194.98 | $812.83 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $302.00 | Professional | None | $223.87 | $251.19 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,344.23 Typical High $4,168.69 | Facility | None | $691.83 | $2,344.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $724.44 Typical High $1,819.70 | Professional | None | $213.80 | $724.44 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,905.46 | Professional | None | $831.76 | $1,122.02 | $1,905.46 |
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 $213.80 Median $831.76 Typical High $2,187.76 | Professional | None | $213.80 | $831.76 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,513.56 | Professional | None | $912.01 | $912.01 | $1,513.56 |
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 $97.72 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $97.72 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $38.90 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $147.91 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $29.51 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $19.50 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $138.04 | $575.44 | $588.84 |
Where Maryland sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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· 42nd of 51
$851
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.