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 $1,230.27 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,230.27 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,174.90 | $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 $1,000.00 Median $1,096.48 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,096.48 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,122.02 | $1,621.81 |
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 $616.60 Median $616.60 Typical High $630.96 | Professional | 52 · Reduced service | $616.60 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $245.47 | $251.19 |
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 $190.55 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $125.89 |
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 5.6 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· 40th 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.