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 $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,258.93 | $1,258.93 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,202.26 | $1,445.44 |
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 $1,148.15 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,148.15 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,148.15 | $1,659.59 |
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 $851.14 Median $1,047.13 Typical High $2,089.30 | Professional | None | $851.14 | $1,047.13 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,412.54 | Professional | None | $891.25 | $891.25 | $1,412.54 |
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 $630.96 Median $630.96 Typical High $645.65 | Professional | 52 · Reduced service | $630.96 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $912.01 |
Where Maryland sits
The same service costs 5.8 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
$1,175
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.