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 $954.99 Median $977.24 Typical High $1,122.02 | Professional | None | $954.99 | $977.24 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,230.27 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,162.28 Typical High $5,248.07 | Facility | None | $512.86 | $3,162.28 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $2,951.21 | Professional | None | $1,047.13 | $1,288.25 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,202.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,513.56 | $2,884.03 |
Wellpoint Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,071.52 | $1,584.89 |
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 $478.63 Median $489.78 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $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· 42nd of 51
$1,288
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.