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 $1,000.00 Median $1,096.48 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,096.48 | $2,089.30 |
CareFirst Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,122.02 | Professional | None | $977.24 | $1,071.52 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,454.71 | Professional | None | $912.01 | $1,122.02 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,659.59 | Professional | None | $977.24 | $1,096.48 | $1,659.59 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $2,398.83 | Professional | None | $851.14 | $1,258.93 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,445.44 | Professional | None | $776.25 | $776.25 | $1,445.44 |
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 $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $776.25 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $776.25 |
Where Maryland sits
The same service costs 6.3 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
$1,122
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.