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 $1,096.48 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,122.02 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,174.90 | $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 $1,000.00 Median $1,202.26 Typical High $3,090.30 | Professional | None | $1,000.00 | $1,202.26 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,778.28 | Professional | None | $977.24 | $1,122.02 | $1,778.28 |
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 $933.25 Median $1,380.38 Typical High $2,570.40 | Professional | None | $933.25 | $1,380.38 | $2,570.40 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,479.11 | Professional | None | $831.76 | $831.76 | $1,479.11 |
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 $549.54 Median $549.54 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | 53 · Discontinued | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $831.76 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $794.33 |
Where Maryland sits
The same service costs 6.3 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· 43rd 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.