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 $1,737.80 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,737.80 | $1,737.80 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,737.80 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $12,022.64 Typical High $21,877.62 | Facility | None | $512.86 | $12,022.64 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $3,162.28 | Professional | None | $1,548.82 | $1,778.28 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,659.59 | $1,819.70 | $3,090.30 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $11,220.18 | Facility | None | $3,090.30 | $7,413.10 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,801.89 | Professional | None | $1,479.11 | $1,778.28 | $3,801.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,659.59 | $2,511.89 |
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 $870.96 Median $870.96 Typical High $912.01 | Professional | 52 · Reduced service | $870.96 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | 53 · Discontinued | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,288.25 |
Where Maryland sits
The same service costs 9.1 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· 43rd of 51
$1,820
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.