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 $1,230.27 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,412.54 | $2,630.27 |
CareFirst Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,288.25 | $1,288.25 |
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 $1,148.15 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,412.54 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,380.38 | $2,089.30 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,659.59 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,047.13 | $1,819.70 |
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 $660.69 Median $660.69 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,000.00 |
Where Maryland sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 44th of 51
$1,288
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.