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 $758.58 Median $776.25 Typical High $891.25 | Professional | None | $758.58 | $776.25 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | None | $933.25 | $1,023.29 | $1,122.02 |
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 $831.76 Median $1,000.00 Typical High $2,344.23 | Professional | None | $831.76 | $1,000.00 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,584.89 | Professional | None | $851.14 | $954.99 | $1,584.89 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $2,238.72 | Professional | None | $812.83 | $1,202.26 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,258.93 | Professional | None | $851.14 | $1,174.90 | $1,258.93 |
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 $380.19 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $562.34 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $616.60 |
Where Maryland sits
The same service costs 6.5 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· 41st of 51
$1,023
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.