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 $891.25 Median $912.01 Typical High $933.25 | Professional | None | $891.25 | $912.01 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,023.29 | Professional | None | $851.14 | $954.99 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $1,819.70 | Facility | None | $512.86 | $977.24 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $2,344.23 | Professional | None | $812.83 | $1,023.29 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,584.89 | Professional | None | $977.24 | $1,096.48 | $1,584.89 |
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 $776.25 Median $1,148.15 Typical High $2,238.72 | Professional | None | $776.25 | $1,148.15 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,445.44 | Professional | None | $776.25 | $776.25 | $1,445.44 |
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 $446.68 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $446.68 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $177.83 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $676.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $645.65 |
Where Maryland sits
The same service costs 5.4 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· 46th of 51
$955
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.