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 $933.25 Median $954.99 Typical High $1,023.29 | Professional | None | $933.25 | $954.99 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | None | $912.01 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $16,982.44 Typical High $28,840.32 | Facility | None | $512.86 | $16,982.44 | $28,840.32 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $2,691.53 | Professional | None | $870.96 | $1,047.13 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,548.82 | Professional | None | $851.14 | $977.24 | $1,548.82 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $2,344.23 | Professional | None | $794.33 | $1,174.90 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,288.25 | Professional | None | $707.95 | $707.95 | $1,288.25 |
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 $467.74 Median $478.63 Typical High $512.86 | Professional | 52 · Reduced service | $467.74 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $204.17 | Professional | 53 · Discontinued | $186.21 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $691.83 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $102.33 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $724.44 |
Where Maryland sits
The same service costs 5.6 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
$1,000
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.