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 $977.24 Median $1,000.00 Typical High $1,288.25 | Professional | None | $977.24 | $1,000.00 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,290.87 Typical High $3,801.89 | Facility | None | $512.86 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,318.26 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,258.93 | $2,041.74 |
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 $1,047.13 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,047.13 | $1,548.82 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,096.48 | $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 $489.78 Median $501.19 Typical High $575.44 | Professional | 52 · Reduced service | $489.78 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $194.98 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $741.31 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $794.33 |
Where Maryland sits
The same service costs 6.5 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
$1,349
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.