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 $2,041.74 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,454.71 | $2,454.71 |
CareFirst Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,344.23 | $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 $1,862.09 Median $2,290.87 Typical High $5,128.61 | Professional | None | $1,862.09 | $2,290.87 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,949.84 | $2,238.72 | $4,073.80 |
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 $1,778.28 Median $2,511.89 Typical High $5,495.41 | Professional | None | $1,778.28 | $2,511.89 | $5,495.41 |
Wellpoint Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,621.81 | $1,621.81 | $2,951.21 |
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 $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,122.02 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $489.78 Typical High $501.19 | Professional | 53 · Discontinued | $446.68 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,698.24 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $338.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,737.80 | $1,737.80 |
Where Maryland sits
The same service costs 5.8 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
$2,089
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.