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 $870.96 Median $977.24 Typical High $1,047.13 | Professional | None | $870.96 | $977.24 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | None | $758.58 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $3,162.28 | Facility | None | $630.96 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $933.25 | Professional | None | $676.08 | $758.58 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,122.02 | Professional | None | $741.31 | $812.83 | $1,122.02 |
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 $537.03 Median $691.83 Typical High $1,479.11 | Professional | None | $537.03 | $691.83 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,148.15 | Professional | None | $588.84 | $588.84 | $1,148.15 |
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 $489.78 Median $489.78 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $194.98 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $154.88 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $724.44 |
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· 40th of 51
$832
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.