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 $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | None | $954.99 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $2,290.87 | Facility | None | $512.86 | $1,288.25 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,584.89 | Professional | None | $776.25 | $912.01 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,862.09 | Professional | None | $912.01 | $1,023.29 | $1,862.09 |
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 $691.83 Median $933.25 Typical High $2,041.74 | Professional | None | $691.83 | $933.25 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,412.54 | Professional | None | $724.44 | $724.44 | $1,412.54 |
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 $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $676.08 |
Where Maryland sits
The same service costs 7.4 times more in Alaska than in Texas. 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· 42nd of 51
$955
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.