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 $3,890.45 Median $3,890.45 Typical High $4,073.80 | Professional | None | $3,890.45 | $3,890.45 | $4,073.80 |
CareFirst Setting Professional Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,168.69 | $4,570.88 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $13,489.63 Typical High $22,908.68 | Facility | None | $512.86 | $13,489.63 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,890.45 Typical High $7,079.46 | Professional | None | $3,467.37 | $3,890.45 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $4,168.69 Typical High $6,918.31 | Professional | None | $3,630.78 | $4,168.69 | $6,918.31 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
United Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $8,511.38 | Professional | None | $3,162.28 | $3,715.35 | $8,511.38 |
Wellpoint Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,495.41 | Professional | None | $3,715.35 | $3,715.35 | $5,495.41 |
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 $1,949.84 Median $1,949.84 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | 53 · Discontinued | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $602.56 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $2,818.38 |
Where Maryland sits
The same service costs 20.4 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· 40th of 51
$4,169
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.