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 $1,318.26 Median $1,348.96 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,348.96 | $1,380.38 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,380.38 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $5,011.87 | Facility | None | $512.86 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,318.26 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,445.44 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,818.38 | Professional | None | $1,047.13 | $1,258.93 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,258.93 | $1,949.84 |
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 $660.69 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $954.99 |
Where Maryland sits
The same service costs 15.1 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
$1,380
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.