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 $1,548.82 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,548.82 | $1,698.24 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,513.56 | $1,584.89 |
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 $1,258.93 Median $1,548.82 Typical High $3,548.13 | Professional | None | $1,258.93 | $1,548.82 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,479.11 | $2,691.53 |
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 $1,258.93 Median $1,778.28 Typical High $3,801.89 | Professional | None | $1,258.93 | $1,778.28 | $3,801.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,122.02 | $1,949.84 |
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 $776.25 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,174.90 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $234.42 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,174.90 | $1,174.90 |
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· 48th of 51
$1,380
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.