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 $1,047.13 Typical High $1,122.02 | Professional | None | $1,047.13 | $1,047.13 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | None | $794.33 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,818.38 | Facility | None | $512.86 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $954.99 | Professional | None | $660.69 | $794.33 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,202.26 | Professional | None | $812.83 | $891.25 | $1,202.26 |
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 $512.86 Median $707.95 Typical High $1,445.44 | Professional | None | $512.86 | $707.95 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,258.93 | Professional | None | $575.44 | $575.44 | $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 $512.86 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $776.25 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $776.25 |
Where Maryland sits
The same service costs 8.3 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· 37th of 51
$891
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.