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 $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,630.78 Typical High $6,025.60 | Facility | None | $512.86 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,905.46 | Professional | None | $933.25 | $1,047.13 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,148.15 | $1,862.09 |
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 $812.83 Median $1,000.00 Typical High $2,238.72 | Professional | None | $812.83 | $1,000.00 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,000.00 | $1,584.89 |
4 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 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $165.96 |
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 $741.31 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $776.25 |
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· 40th of 51
$1,096
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.