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 $1,819.70 Median $1,819.70 Typical High $1,862.09 | Professional | None | $1,819.70 | $1,819.70 | $1,862.09 |
CareFirst Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,862.09 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,630.78 Typical High $6,025.60 | Facility | None | $512.86 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,778.28 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,137.96 | $3,162.28 |
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 $1,096.48 Median $1,621.81 Typical High $3,801.89 | Professional | None | $1,096.48 | $1,621.81 | $3,801.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,380.38 | $2,884.03 |
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 $891.25 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 53 · Discontinued | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,318.26 |
Where Maryland sits
The same service costs 11.2 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· 38th of 51
$1,862
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.