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 $1,000.00 | Professional | None | $954.99 | $954.99 | $1,000.00 |
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 $1,000.00 Median $8,912.51 Typical High $14,791.08 | Facility | None | $1,000.00 | $8,912.51 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,698.24 | Professional | None | $851.14 | $954.99 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,698.24 | Professional | None | $912.01 | $1,047.13 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $2,041.74 | Professional | None | $758.58 | $912.01 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,412.54 | Professional | None | $933.25 | $933.25 | $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 $478.63 Median $478.63 Typical High $501.19 | Professional | 52 · Reduced service | $478.63 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 53 · Discontinued | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $707.95 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $691.83 |
Where Maryland sits
The same service costs 7.9 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· 43rd of 51
$1,000
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.