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 $954.99 Median $1,000.00 Typical High $1,023.29 | Professional | None | $954.99 | $1,000.00 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,122.02 | Professional | None | $870.96 | $954.99 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,000.00 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,398.83 | Professional | None | $831.76 | $1,047.13 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,659.59 | Professional | None | $870.96 | $1,000.00 | $1,659.59 |
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 $1,202.26 Typical High $2,290.87 | Professional | None | $812.83 | $1,202.26 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,318.26 | Professional | None | $812.83 | $812.83 | $1,318.26 |
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 $478.63 Median $501.19 Typical High $512.86 | Professional | 52 · Reduced service | $478.63 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $204.17 | Professional | 53 · Discontinued | $190.55 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $758.58 | Professional | 54 · Surgery only | $724.44 | $741.31 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $707.95 |
Where Maryland sits
The same service costs 7.2 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· 41st of 51
$1,096
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.