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 $1,023.29 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,047.13 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,412.54 | $1,513.56 |
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 $1,122.02 Median $1,412.54 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,412.54 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,318.26 | $2,187.76 |
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 $1,122.02 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,659.59 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,148.15 | $1,737.80 |
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 $512.86 Median $524.81 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $912.01 | Professional | 54 · Surgery only | $776.25 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $181.97 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $851.14 |
Where Maryland sits
The same service costs 7.1 times more in Alaska than in Texas. 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
$1,259
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.