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 $912.01 Median $912.01 Typical High $977.24 | Professional | None | $912.01 | $912.01 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | None | $691.83 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,818.38 | Facility | None | $512.86 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $831.76 | Professional | None | $562.34 | $691.83 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,047.13 | Professional | None | $707.95 | $776.25 | $1,047.13 |
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 $446.68 Median $616.60 Typical High $1,258.93 | Professional | None | $446.68 | $616.60 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,096.48 | Professional | None | $501.19 | $501.19 | $1,096.48 |
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 $457.09 Median $457.09 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | 53 · Discontinued | $181.97 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $676.08 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $676.08 |
Where Maryland sits
The same service costs 8.5 times more in Wyoming 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· 39th of 51
$776
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.