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 $1,174.90 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,949.84 | $2,137.96 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $6,456.54 | Facility | None | $707.95 | $3,801.89 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,000.00 | $1,778.28 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $3,981.07 | Professional | None | $2,137.96 | $2,454.71 | $3,981.07 |
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 $794.33 Median $1,698.24 Typical High $3,801.89 | Professional | None | $794.33 | $1,698.24 | $3,801.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,862.09 | $1,862.09 | $3,388.44 |
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 $588.84 Median $676.08 Typical High $1,071.52 | Professional | 52 · Reduced service | $588.84 | $676.08 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $269.15 Typical High $436.52 | Professional | 53 · Discontinued | $234.42 | $269.15 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,621.81 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $323.59 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $134.90 Typical High $213.80 | Professional | 56 · Pre-op care only | $117.49 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $1,513.56 |
Where Maryland sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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· 42nd of 51
$1,622
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.