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 $2,630.27 Median $2,754.23 Typical High $2,884.03 | Professional | None | $2,630.27 | $2,754.23 | $2,884.03 |
CareFirst Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,454.71 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $6,165.95 | Professional | None | $2,187.76 | $2,691.53 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $4,265.80 | Professional | None | $2,238.72 | $2,570.40 | $4,265.80 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $6,025.60 | Professional | None | $2,089.30 | $3,162.28 | $6,025.60 |
Wellpoint Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,995.26 | $1,995.26 | $3,388.44 |
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 $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 53 · Discontinued | $524.81 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $2,041.74 |
Where Maryland sits
The same service costs 11.0 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· 39th of 51
$2,512
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.