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 $933.25 Median $1,047.13 Typical High $1,174.90 | Professional | None | $933.25 | $1,047.13 | $1,174.90 |
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 $512.86 Median $2,951.21 Typical High $5,011.87 | Facility | None | $512.86 | $2,951.21 | $5,011.87 |
Cigna 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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,737.80 | Professional | None | $912.01 | $1,047.13 | $1,737.80 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $2,344.23 | Professional | None | $707.95 | $1,071.52 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,380.38 | Professional | None | $562.34 | $562.34 | $1,380.38 |
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 $512.86 Median $524.81 Typical High $588.84 | Professional | 52 · Reduced service | $512.86 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $776.25 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $812.83 |
Where Maryland sits
The same service costs 6.9 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
$1,047
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.