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 $1,096.48 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,096.48 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $13,803.84 Typical High $25,118.86 | Facility | None | $512.86 | $13,803.84 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,995.26 | Professional | None | $977.24 | $1,096.48 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,230.27 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,168.69 Typical High $15,135.61 | Facility | None | $1,621.81 | $4,168.69 | $15,135.61 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,398.83 | Professional | None | $891.25 | $1,071.52 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,071.52 | $1,621.81 |
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 $549.54 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $812.83 |
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· 42nd of 51
$1,148
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.