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 $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,380.38 | $1,380.38 | $1,445.44 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,348.96 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $3,019.95 | Facility | None | $630.96 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,380.38 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,548.82 | $2,511.89 |
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 $1,000.00 Median $1,288.25 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,288.25 | $2,884.03 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,174.90 | $2,137.96 |
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 $691.83 Median $691.83 Typical High $724.44 | Professional | 52 · Reduced service | $691.83 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | 53 · Discontinued | $275.42 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,023.29 |
Where Maryland sits
The same service costs 7.9 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· 40th of 51
$1,380
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.