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 $616.60 Median $616.60 Typical High $645.65 | Professional | None | $616.60 | $616.60 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | None | $588.84 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,737.80 | Facility | None | $446.68 | $977.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,122.02 | Professional | None | $501.19 | $588.84 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,148.15 | Professional | None | $691.83 | $758.58 | $1,148.15 |
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 $426.58 Median $575.44 Typical High $1,258.93 | Professional | None | $426.58 | $575.44 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,047.13 | Professional | None | $501.19 | $501.19 | $1,047.13 |
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 $309.03 Median $309.03 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $457.09 |
Where Maryland sits
The same service costs 5.5 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· 42nd of 51
$631
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.