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 $2,630.27 Median $2,630.27 Typical High $2,691.53 | Professional | None | $2,630.27 | $2,630.27 | $2,691.53 |
CareFirst Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,754.23 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,677.35 Typical High $8,511.38 | Facility | None | $512.86 | $4,677.35 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,290.87 | $2,570.40 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $4,677.35 | Professional | None | $2,454.71 | $2,818.38 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $5,754.40 | Professional | None | $2,089.30 | $2,511.89 | $5,754.40 |
Wellpoint Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,715.35 | Professional | None | $2,511.89 | $2,511.89 | $3,715.35 |
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 $1,318.26 Median $1,318.26 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | 53 · Discontinued | $524.81 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,905.46 |
Where Maryland sits
The same service costs 8.7 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· 39th of 51
$2,754
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.