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 $1,380.38 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,380.38 | $1,380.38 |
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 $1,071.52 Median $1,174.90 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,174.90 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,288.25 | $2,238.72 |
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 $977.24 Median $1,380.38 Typical High $3,162.28 | Professional | None | $977.24 | $1,380.38 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,698.24 | Professional | None | $891.25 | $891.25 | $1,698.24 |
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 $616.60 Median $676.08 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,047.13 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $977.24 |
Where Maryland sits
The same service costs 5.1 times more in Alaska 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· 42nd 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.