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 $1,047.13 Median $1,071.52 Typical High $1,096.48 | Professional | None | $1,047.13 | $1,071.52 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $2,691.53 | Facility | None | $512.86 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $2,754.23 | Professional | None | $977.24 | $1,148.15 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,288.25 | $1,862.09 |
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 $851.14 Median $1,288.25 Typical High $2,630.27 | Professional | None | $851.14 | $1,288.25 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,659.59 | Professional | None | $794.33 | $794.33 | $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 $524.81 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $524.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $758.58 |
Where Maryland sits
The same service costs 6.6 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· 38th of 51
$1,230
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.