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 $933.25 Median $933.25 Typical High $1,000.00 | Professional | None | $933.25 | $933.25 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | None | $724.44 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $2,398.83 | Facility | None | $707.95 | $1,288.25 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $954.99 | Professional | None | $691.83 | $724.44 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,071.52 | Professional | None | $707.95 | $776.25 | $1,071.52 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,513.56 | Professional | None | $537.03 | $691.83 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,071.52 | Professional | None | $616.60 | $616.60 | $1,071.52 |
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 $186.21 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $186.21 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $691.83 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $691.83 |
Where Maryland sits
The same service costs 7.6 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· 43rd 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.