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 $2,238.72 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,238.72 | $2,511.89 | $2,511.89 |
CareFirst Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $2,570.40 | Professional | None | $2,137.96 | $2,398.83 | $2,570.40 |
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 $1,905.46 Median $2,344.23 Typical High $5,248.07 | Professional | None | $1,905.46 | $2,344.23 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,290.87 | $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 $1,862.09 Median $2,630.27 Typical High $5,623.41 | Professional | None | $1,862.09 | $2,630.27 | $5,623.41 |
Wellpoint Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,659.59 | $1,659.59 | $3,019.95 |
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 $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,174.90 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,737.80 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $234.42 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,778.28 | $1,778.28 |
Where Maryland sits
The same service costs 5.2 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· 44th of 51
$2,138
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.