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 $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,698.24 | $1,737.80 | $1,737.80 |
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 $12,882.50 Typical High $21,877.62 | Facility | None | $512.86 | $12,882.50 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,659.59 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,659.59 | $1,905.46 | $2,951.21 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,413.10 Typical High $23,442.29 | Facility | None | $3,019.95 | $7,413.10 | $23,442.29 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,630.78 | Professional | None | $1,258.93 | $1,584.89 | $3,630.78 |
Wellpoint Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,548.82 | $2,570.40 |
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 $851.14 Median $851.14 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 53 · Discontinued | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,230.27 |
Where Maryland sits
The same service costs 8.5 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· 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.