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 $2,290.87 Median $2,570.40 Typical High $2,630.27 | Professional | None | $2,290.87 | $2,570.40 | $2,630.27 |
CareFirst Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,089.30 | $2,344.23 | $2,344.23 |
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 $5,370.32 | Professional | None | $1,905.46 | $2,344.23 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,238.72 | $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 $1,659.59 Median $2,454.71 Typical High $5,754.40 | Professional | None | $1,659.59 | $2,454.71 | $5,754.40 |
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 $1,288.25 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,174.90 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $512.86 Typical High $524.81 | Professional | 53 · Discontinued | $467.74 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,737.80 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $257.04 Typical High $263.03 | Professional | 56 · Pre-op care only | $234.42 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,819.70 | $1,819.70 |
Where Maryland sits
The same service costs 5.6 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· 42nd 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.