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 $478.63 Median $1,202.26 Typical High $1,659.59 | Professional | None | $478.63 | $1,202.26 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | None | $371.54 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $2,884.03 | Facility | None | $512.86 | $1,659.59 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,023.29 Typical High $2,238.72 | Professional | None | $389.05 | $1,023.29 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,659.59 | $2,754.23 |
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 $363.08 Median $1,122.02 Typical High $2,884.03 | Professional | None | $363.08 | $1,122.02 | $2,884.03 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,238.72 | Professional | None | $933.25 | $933.25 | $2,238.72 |
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 $239.88 Median $436.52 Typical High $831.76 | Professional | 52 · Reduced service | $239.88 | $436.52 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $173.78 Typical High $331.13 | Professional | 53 · Discontinued | $95.50 | $173.78 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $645.65 Typical High $1,258.93 | Professional | 54 · Surgery only | $354.81 | $645.65 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $128.82 Typical High $251.19 | Professional | 55 · Aftercare only | $72.44 | $128.82 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $87.10 Typical High $165.96 | Professional | 56 · Pre-op care only | $47.86 | $87.10 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $602.56 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $331.13 | $602.56 | $1,174.90 |
Where Maryland sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 42nd of 51
$1,230
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.