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 $1,122.02 Median $1,122.02 Typical High $1,148.15 | Professional | None | $1,122.02 | $1,122.02 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,288.25 | Professional | None | $977.24 | $1,071.52 | $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 $954.99 Median $1,000.00 Typical High $1,584.89 | Professional | None | $954.99 | $1,000.00 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,445.44 | Professional | None | $912.01 | $1,000.00 | $1,445.44 |
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 $776.25 Median $933.25 Typical High $1,862.09 | Professional | None | $776.25 | $933.25 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,230.27 | Professional | None | $812.83 | $812.83 | $1,230.27 |
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 $562.34 Median $562.34 Typical High $575.44 | Professional | 52 · Reduced service | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $812.83 |
Where Maryland sits
The same service costs 5.2 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· 41st of 51
$1,023
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.