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 $416.87 Median $891.25 Typical High $1,995.26 | Professional | None | $416.87 | $891.25 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | None | $323.59 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $2,691.53 | Facility | None | $512.86 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $891.25 Typical High $2,691.53 | Professional | None | $331.13 | $891.25 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,949.84 | $3,019.95 |
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 $316.23 Median $1,047.13 Typical High $3,235.94 | Professional | None | $316.23 | $1,047.13 | $3,235.94 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,691.53 | Professional | None | $1,000.00 | $1,000.00 | $2,691.53 |
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 $208.93 Median $446.68 Typical High $1,000.00 | Professional | 52 · Reduced service | $208.93 | $446.68 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $177.83 Typical High $398.11 | Professional | 53 · Discontinued | $83.18 | $177.83 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $660.69 Typical High $1,479.11 | Professional | 54 · Surgery only | $309.03 | $660.69 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $131.83 Typical High $295.12 | Professional | 55 · Aftercare only | $61.66 | $131.83 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $89.13 Typical High $199.53 | Professional | 56 · Pre-op care only | $41.69 | $89.13 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $616.60 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $288.40 | $616.60 | $1,380.38 |
Where Maryland sits
The same service costs 5.8 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· 41st of 51
$1,349
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.