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 $1,122.02 Median $1,122.02 Typical High $1,148.15 | Professional | None | $1,122.02 | $1,122.02 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $977.24 Typical High $1,819.70 | Facility | None | $457.09 | $977.24 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,041.74 | Professional | None | $831.76 | $1,047.13 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,288.25 | $1,949.84 |
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 $630.96 Median $1,000.00 Typical High $2,290.87 | Professional | None | $630.96 | $1,000.00 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,737.80 | Professional | None | $758.58 | $758.58 | $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 $549.54 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $831.76 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $794.33 |
Where Maryland sits
The same service costs 5.9 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· 39th of 51
$1,122
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.