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 $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,000.00 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | None | $776.25 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,398.83 | Facility | None | $630.96 | $1,288.25 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,071.52 | Professional | None | $741.31 | $776.25 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,202.26 | Professional | None | $758.58 | $831.76 | $1,202.26 |
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 $588.84 Median $758.58 Typical High $1,621.81 | Professional | None | $588.84 | $758.58 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,148.15 | Professional | None | $660.69 | $660.69 | $1,148.15 |
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 $501.19 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $741.31 |
Where Maryland sits
The same service costs 7.2 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· 41st of 51
$871
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.