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 $2,137.96 Median $2,398.83 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,398.83 | $2,454.71 |
CareFirst Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,630.27 | Professional | None | $2,041.74 | $2,290.87 | $2,630.27 |
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 $1,819.70 Median $2,238.72 Typical High $5,011.87 | Professional | None | $1,819.70 | $2,238.72 | $5,011.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $3,981.07 | Professional | None | $1,905.46 | $2,187.76 | $3,981.07 |
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 $5,370.32 | Professional | None | $1,778.28 | $2,511.89 | $5,370.32 |
Wellpoint Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,659.59 | $1,659.59 | $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 $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,096.48 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $478.63 Typical High $489.78 | Professional | 53 · Discontinued | $436.52 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,659.59 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $239.88 Typical High $245.47 | Professional | 56 · Pre-op care only | $218.78 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,698.24 | $1,698.24 |
Where Maryland sits
The same service costs 6.0 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
$2,042
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.