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 $1,995.26 Median $2,344.23 Typical High $2,398.83 | Professional | None | $1,995.26 | $2,344.23 | $2,398.83 |
CareFirst Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,995.26 | $2,238.72 | $2,238.72 |
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 $1,778.28 Median $2,187.76 Typical High $4,897.79 | Professional | None | $1,778.28 | $2,187.76 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,137.96 | $3,890.45 |
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 $1,737.80 Median $2,511.89 Typical High $5,248.07 | Professional | None | $1,737.80 | $2,511.89 | $5,248.07 |
Wellpoint Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,698.24 | $2,818.38 |
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 $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $467.74 Typical High $478.63 | Professional | 53 · Discontinued | $436.52 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,621.81 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $323.59 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $234.42 Typical High $239.88 | Professional | 56 · Pre-op care only | $218.78 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,659.59 | $1,659.59 |
Where Maryland sits
The same service costs 5.5 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
$1,995
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.