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 $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,318.26 | $1,318.26 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,897.79 Typical High $8,128.31 | Facility | None | $512.86 | $4,897.79 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,258.93 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,348.96 | $2,238.72 |
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 $1,071.52 Median $1,258.93 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,258.93 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,230.27 | $1,819.70 |
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 $630.96 Median $630.96 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $912.01 |
Where Maryland sits
The same service costs 8.1 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· 41st of 51
$1,318
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.