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 $2,570.40 Median $2,570.40 Typical High $2,754.23 | Professional | None | $2,570.40 | $2,570.40 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,818.38 | $2,818.38 |
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 $2,238.72 Median $2,691.53 Typical High $6,165.95 | Professional | None | $2,238.72 | $2,691.53 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $4,168.69 | Professional | None | $2,398.83 | $2,691.53 | $4,168.69 |
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 $1,949.84 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,949.84 | $1,949.84 | $3,548.13 |
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 $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | 53 · Discontinued | $512.86 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $275.42 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,949.84 |
Where Maryland sits
The same service costs 7.1 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· 37th of 51
$2,570
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.