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 $4,466.84 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,466.84 | $5,011.87 | $5,011.87 |
CareFirst Setting Professional Modifier None Typical Low $4,265.80 Median $4,677.35 Typical High $4,786.30 | Professional | None | $4,265.80 | $4,677.35 | $4,786.30 |
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 $3,715.35 Median $4,570.88 Typical High $10,471.29 | Professional | None | $3,715.35 | $4,570.88 | $10,471.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $8,128.31 | Professional | None | $3,890.45 | $4,365.16 | $8,128.31 |
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 $3,019.95 Median $4,897.79 Typical High $11,220.18 | Professional | None | $3,019.95 | $4,897.79 | $11,220.18 |
Wellpoint Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $5,888.44 | Professional | None | $3,311.31 | $3,311.31 | $5,888.44 |
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 $2,290.87 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,290.87 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $912.01 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,467.37 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $741.31 Typical High $758.58 | Professional | 55 · Aftercare only | $691.83 | $741.31 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,467.37 | $3,467.37 |
Where Maryland sits
The same service costs 9.3 times more in Alaska than in Arkansas. 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
$4,169
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.