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 $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | None | $1,000.00 | $1,000.00 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,090.30 Typical High $5,011.87 | Facility | None | $707.95 | $3,090.30 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,778.28 | Professional | None | $891.25 | $1,000.00 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,778.28 | Professional | None | $977.24 | $1,122.02 | $1,778.28 |
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 $776.25 Median $954.99 Typical High $2,137.96 | Professional | None | $776.25 | $954.99 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,479.11 | Professional | None | $977.24 | $977.24 | $1,479.11 |
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 $501.19 Median $501.19 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $794.33 | Professional | 54 · Surgery only | $741.31 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $741.31 |
Where Maryland sits
The same service costs 21.4 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
$1,047
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.