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 $1,071.52 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,071.52 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $6,456.54 Typical High $10,964.78 | Facility | None | $446.68 | $6,456.54 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,905.46 | Professional | None | $954.99 | $1,000.00 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,148.15 | $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 $812.83 Median $1,000.00 Typical High $2,187.76 | Professional | None | $812.83 | $1,000.00 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,000.00 | $1,513.56 |
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 $512.86 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $758.58 |
Where Maryland sits
The same service costs 6.2 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
$1,072
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.