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 $1,288.25 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,288.25 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,348.96 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $9,332.54 Typical High $15,488.17 | Facility | None | $512.86 | $9,332.54 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,288.25 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,412.54 | $2,290.87 |
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 $1,000.00 Median $1,230.27 Typical High $2,818.38 | Professional | None | $1,000.00 | $1,230.27 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,230.27 | $1,905.46 |
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 $645.65 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $645.65 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $933.25 |
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· 40th of 51
$1,349
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.