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 $1,202.26 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,202.26 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,090.30 Typical High $5,248.07 | Facility | None | $512.86 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,511.89 | Professional | None | $912.01 | $1,122.02 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,949.84 | Professional | None | $933.25 | $1,071.52 | $1,949.84 |
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 $891.25 Median $1,318.26 Typical High $2,691.53 | Professional | None | $891.25 | $1,318.26 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,412.54 | Professional | None | $851.14 | $851.14 | $1,412.54 |
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 $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $549.54 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $165.96 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $851.14 | $851.14 |
Where Maryland sits
The same service costs 5.0 times more in Wisconsin 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· 41st of 51
$1,318
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.