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 $2,951.21 Median $3,311.31 Typical High $3,388.44 | Professional | None | $2,951.21 | $3,311.31 | $3,388.44 |
CareFirst Setting Professional Modifier None Typical Low $2,818.38 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,818.38 | $3,162.28 | $3,162.28 |
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 $2,454.71 Median $3,090.30 Typical High $6,918.31 | Professional | None | $2,454.71 | $3,090.30 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $5,495.41 | Professional | None | $2,630.27 | $3,019.95 | $5,495.41 |
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 $2,238.72 Median $3,235.94 Typical High $7,413.10 | Professional | None | $2,238.72 | $3,235.94 | $7,413.10 |
Wellpoint Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,981.07 | Professional | None | $2,187.76 | $2,187.76 | $3,981.07 |
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 $1,548.82 Median $1,659.59 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,548.82 | $1,659.59 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $660.69 Typical High $676.08 | Professional | 53 · Discontinued | $616.60 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,290.87 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $331.13 Typical High $338.84 | Professional | 56 · Pre-op care only | $309.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,344.23 | $2,344.23 |
Where Maryland sits
The same service costs 5.8 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· 39th of 51
$2,818
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.