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 $489.78 Median $588.84 Typical High $724.44 | Professional | None | $489.78 | $588.84 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $562.34 | Professional | None | $446.68 | $501.19 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $2,691.53 | Facility | None | $512.86 | $1,513.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,348.96 | Professional | None | $478.63 | $691.83 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,148.15 | Professional | None | $676.08 | $794.33 | $1,148.15 |
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 $436.52 Median $741.31 Typical High $1,318.26 | Professional | None | $436.52 | $741.31 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,071.52 | Professional | None | $416.87 | $416.87 | $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 $245.47 Median $269.15 Typical High $363.08 | Professional | 52 · Reduced service | $245.47 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $144.54 | Professional | 53 · Discontinued | $97.72 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $549.54 | Professional | 54 · Surgery only | $363.08 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $109.65 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $72.44 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $512.86 |
Where Maryland sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 41st of 51
$692
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.