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 $2,951.21 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,951.21 | $2,951.21 | $3,090.30 |
CareFirst Setting Professional Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,951.21 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,570.88 Typical High $7,585.78 | Facility | None | $630.96 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $5,370.32 | Professional | None | $2,570.40 | $2,951.21 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,235.94 Typical High $5,248.07 | Professional | None | $2,818.38 | $3,235.94 | $5,248.07 |
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 $2,818.38 Typical High $6,456.54 | Professional | None | $2,089.30 | $2,818.38 | $6,456.54 |
Wellpoint Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $4,265.80 | Professional | None | $2,630.27 | $2,630.27 | $4,265.80 |
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 $1,479.11 Median $1,479.11 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $616.60 | Professional | 53 · Discontinued | $588.84 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $309.03 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,137.96 |
Where Maryland sits
The same service costs 19.1 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
$3,020
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.