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 $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,202.26 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,148.15 | $1,412.54 |
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 $977.24 Median $1,096.48 Typical High $1,659.59 | Professional | None | $977.24 | $1,096.48 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,096.48 | $1,584.89 |
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 $831.76 Median $1,023.29 Typical High $2,041.74 | Professional | None | $831.76 | $1,023.29 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,348.96 | Professional | None | $870.96 | $870.96 | $1,348.96 |
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 $602.56 Median $602.56 Typical High $616.60 | Professional | 52 · Reduced service | $602.56 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $245.47 | Professional | 53 · Discontinued | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | 54 · Surgery only | $912.01 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $870.96 |
Where Maryland sits
The same service costs 5.9 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· 37th of 51
$1,122
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.