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 $812.83 Median $812.83 Typical High $1,023.29 | Professional | None | $812.83 | $812.83 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,148.15 | Professional | None | $977.24 | $1,096.48 | $1,148.15 |
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 $870.96 Median $1,071.52 Typical High $2,454.71 | Professional | None | $870.96 | $1,071.52 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,698.24 | Professional | None | $912.01 | $1,023.29 | $1,698.24 |
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 $851.14 Median $1,258.93 Typical High $2,398.83 | Professional | None | $851.14 | $1,258.93 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,348.96 | Professional | None | $912.01 | $912.01 | $1,348.96 |
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 $398.11 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $660.69 |
Where Maryland sits
The same service costs 6.2 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· 41st of 51
$1,072
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.