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 $1,659.59 Typical High $1,698.24 | Professional | None | $1,513.56 | $1,659.59 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,584.89 | $1,737.80 |
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 $1,288.25 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,548.82 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,584.89 | $2,818.38 |
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 $1,230.27 Median $1,698.24 Typical High $3,715.35 | Professional | None | $1,230.27 | $1,698.24 | $3,715.35 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,122.02 | $2,089.30 |
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 $776.25 Median $831.76 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $331.13 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $165.96 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,174.90 |
Where Maryland sits
The same service costs 5.4 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· 43rd of 51
$1,445
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.