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 $1,584.89 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,584.89 | $1,584.89 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,659.59 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,715.35 Typical High $6,309.57 | Facility | None | $512.86 | $3,715.35 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,621.81 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,737.80 | $2,818.38 |
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 $1,258.93 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,548.82 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,445.44 | $2,344.23 |
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 $794.33 Median $794.33 Typical High $831.76 | Professional | 52 · Reduced service | $794.33 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | 53 · Discontinued | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,174.90 |
Where Maryland sits
The same service costs 19.5 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· 43rd of 51
$1,660
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.