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 $380.19 Median $398.11 Typical High $2,754.23 | Professional | None | $380.19 | $398.11 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | None | $436.52 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $8,709.64 Typical High $16,218.10 | Facility | None | $331.13 | $8,709.64 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $446.68 Typical High $3,890.45 | Professional | None | $169.82 | $446.68 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,570.88 Median $5,623.41 Typical High $7,762.47 | Professional | None | $4,570.88 | $5,623.41 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $134.90 Median $316.23 Typical High $3,162.28 | Professional | None | $134.90 | $316.23 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $8,317.64 | Professional | None | $194.98 | $194.98 | $8,317.64 |
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 $190.55 Median $199.53 Typical High $1,380.38 | Professional | 52 · Reduced service | $190.55 | $199.53 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $549.54 | Professional | 53 · Discontinued | $75.86 | $79.43 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $2,041.74 | Professional | 54 · Surgery only | $288.40 | $302.00 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $416.87 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $275.42 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $1,905.46 |
Where Maryland sits
The same service costs 17.4 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· 41st of 51
$490
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.