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 $645.65 Median $660.69 Typical High $1,348.96 | Professional | None | $645.65 | $660.69 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $954.99 | Professional | None | $758.58 | $831.76 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,290.87 Typical High $3,801.89 | Facility | None | $512.86 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,995.26 | Professional | None | $691.83 | $851.14 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,348.96 | Professional | None | $741.31 | $851.14 | $1,348.96 |
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 $660.69 Median $1,000.00 Typical High $1,905.46 | Professional | None | $660.69 | $1,000.00 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,122.02 | Professional | None | $691.83 | $691.83 | $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 $323.59 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $323.59 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $501.19 |
Where Maryland sits
The same service costs 6.6 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· 42nd of 51
$891
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.