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 $1,174.90 Typical High $1,174.90 | Professional | None | $1,096.48 | $1,174.90 | $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 $1,621.81 Typical High $2,691.53 | Facility | None | $512.86 | $1,621.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $2,454.71 | Professional | None | $891.25 | $1,096.48 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,905.46 | Professional | None | $912.01 | $1,047.13 | $1,905.46 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $2,630.27 | Professional | None | $870.96 | $1,288.25 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,380.38 | Professional | None | $912.01 | $912.01 | $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 $549.54 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $549.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $831.76 |
Where Maryland sits
The same service costs 4.6 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· 43rd of 51
$1,175
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.