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 $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,122.02 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
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 $1,000.00 Median $1,122.02 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,122.02 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,258.93 | $1,995.26 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,454.71 | Professional | None | $912.01 | $1,071.52 | $2,454.71 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,096.48 | $1,698.24 |
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 $562.34 Median $562.34 Typical High $588.84 | Professional | 52 · Reduced service | $562.34 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | 53 · Discontinued | $223.87 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | 54 · Surgery only | $851.14 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $812.83 |
Where Maryland sits
The same service costs 8.5 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· 44th of 51
$1,122
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.