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 $1,621.81 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,621.81 | $1,621.81 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $9,332.54 Typical High $15,488.17 | Facility | None | $512.86 | $9,332.54 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,445.44 | $1,621.81 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,778.28 | $2,884.03 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $3,548.13 | Professional | None | $1,258.93 | $1,548.82 | $3,548.13 |
Wellpoint Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,548.82 | $2,344.23 |
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 $812.83 Median $812.83 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,174.90 |
Where Maryland sits
The same service costs 17.0 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
$1,698
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.