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 $645.65 Median $724.44 Typical High $977.24 | Professional | None | $645.65 | $724.44 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | None | $501.19 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,122.02 Typical High $2,089.30 | Facility | None | $630.96 | $1,122.02 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $831.76 | Professional | None | $478.63 | $660.69 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,202.26 | Professional | None | $741.31 | $851.14 | $1,202.26 |
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 $416.87 Median $575.44 Typical High $1,071.52 | Professional | None | $416.87 | $575.44 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,230.27 | Professional | None | $575.44 | $575.44 | $1,230.27 |
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 $323.59 Median $346.74 Typical High $489.78 | Professional | 52 · Reduced service | $323.59 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $194.98 | Professional | 53 · Discontinued | $128.82 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $724.44 | Professional | 54 · Surgery only | $478.63 | $512.86 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $144.54 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $676.08 |
Where Maryland sits
The same service costs 4.8 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
$646
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.