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 $1,148.15 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,148.15 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | None | $891.25 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $3,162.28 | Facility | None | $630.96 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,096.48 | Professional | None | $758.58 | $891.25 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,348.96 | Professional | None | $891.25 | $977.24 | $1,348.96 |
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 $602.56 Median $794.33 Typical High $1,659.59 | Professional | None | $602.56 | $794.33 | $1,659.59 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,380.38 | Professional | None | $676.08 | $676.08 | $1,380.38 |
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 $575.44 Median $575.44 Typical High $616.60 | Professional | 52 · Reduced service | $575.44 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $870.96 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $870.96 |
Where Maryland sits
The same service costs 7.6 times more in Wyoming 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· 38th of 51
$1,000
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.