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 $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $5,011.87 Typical High $8,317.64 | Facility | None | $512.86 | $5,011.87 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $3,467.37 | Professional | None | $1,122.02 | $1,348.96 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,258.93 | $1,995.26 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,548.82 | $2,884.03 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,659.59 | Professional | None | $933.25 | $933.25 | $1,659.59 |
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 $933.25 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $933.25 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $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 $870.96 Median $870.96 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $891.25 |
Where Maryland sits
The same service costs 5.6 times more in Wisconsin 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
$1,318
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.