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 $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,659.59 | $1,737.80 |
CareFirst Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,621.81 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,691.53 | Facility | None | $446.68 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,621.81 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,621.81 | $1,862.09 | $3,019.95 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $3,548.13 | Professional | None | $1,122.02 | $1,584.89 | $3,548.13 |
Wellpoint Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,412.54 | $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 $831.76 Median $831.76 Typical High $870.96 | Professional | 52 · Reduced service | $831.76 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $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 $165.96 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,230.27 |
Where Maryland sits
The same service costs 7.8 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· 42nd 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.