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 $851.14 Median $954.99 Typical High $1,000.00 | Professional | None | $851.14 | $954.99 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | None | $741.31 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,398.83 | Facility | None | $1,000.00 | $1,288.25 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $933.25 | Professional | None | $707.95 | $724.44 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,071.52 | Professional | None | $707.95 | $794.33 | $1,071.52 |
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 $549.54 Median $691.83 Typical High $1,548.82 | Professional | None | $549.54 | $691.83 | $1,548.82 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,096.48 | Professional | None | $616.60 | $616.60 | $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 $467.74 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 53 · Discontinued | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $707.95 |
Where Maryland sits
The same service costs 7.2 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· 39th of 51
$813
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.