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 $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | None | $1,071.52 | $1,071.52 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,148.15 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,023.29 Typical High $1,819.70 | Facility | None | $512.86 | $1,023.29 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $3,090.30 | Professional | None | $977.24 | $1,174.90 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,737.80 | Professional | None | $954.99 | $1,096.48 | $1,737.80 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $2,511.89 | Professional | None | $891.25 | $1,348.96 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,445.44 | Professional | None | $812.83 | $812.83 | $1,445.44 |
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 $537.03 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | 54 · Surgery only | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $776.25 |
Where Maryland sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$1,096
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.