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 $3,311.31 Median $3,801.89 Typical High $7,585.78 | Professional | None | $3,311.31 | $3,801.89 | $7,585.78 |
CareFirst Setting Professional Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $4,073.80 | Professional | None | $3,235.94 | $3,630.78 | $4,073.80 |
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 $2,884.03 Median $3,548.13 Typical High $7,943.28 | Professional | None | $2,884.03 | $3,548.13 | $7,943.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,019.95 Median $3,467.37 Typical High $6,309.57 | Professional | None | $3,019.95 | $3,467.37 | $6,309.57 |
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 $2,754.23 Median $3,890.45 Typical High $8,511.38 | Professional | None | $2,754.23 | $3,890.45 | $8,511.38 |
Wellpoint Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $4,570.88 | Professional | None | $2,570.40 | $2,570.40 | $4,570.88 |
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 $1,778.28 Median $1,905.46 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,778.28 | $1,905.46 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,630.27 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $537.03 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $380.19 Typical High $389.05 | Professional | 56 · Pre-op care only | $354.81 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,691.53 | $2,691.53 |
Where Maryland sits
The same service costs 6.2 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· 41st of 51
$3,236
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.