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 $1,318.26 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,479.11 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,090.30 Typical High $5,011.87 | Facility | None | $707.95 | $3,090.30 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,445.44 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,621.81 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,659.59 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,000.00 | $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 $660.69 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,174.90 |
Where Maryland sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 37th 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.