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 $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,513.56 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,584.89 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $2,691.53 | Facility | None | $512.86 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,513.56 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,659.59 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,380.38 Typical High $3,311.31 | Professional | None | $724.44 | $1,380.38 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,202.26 | $2,238.72 |
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 $758.58 Median $758.58 Typical High $794.33 | Professional | 52 · Reduced service | $758.58 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,122.02 |
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· 39th of 51
$1,585
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.