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 $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | None | $1,047.13 | $1,047.13 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,698.24 Typical High $3,019.95 | Facility | None | $707.95 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,862.09 | Professional | None | $870.96 | $1,047.13 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,122.02 | $1,862.09 |
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 $724.44 Median $1,000.00 Typical High $2,238.72 | Professional | None | $724.44 | $1,000.00 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,548.82 | Professional | None | $891.25 | $891.25 | $1,548.82 |
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 $524.81 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $758.58 |
Where Maryland sits
The same service costs 7.6 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· 39th 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.