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 $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,548.82 | $1,548.82 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,348.96 | $1,479.11 |
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 $1,174.90 Median $1,445.44 Typical High $3,235.94 | Professional | None | $1,174.90 | $1,445.44 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,380.38 | $2,511.89 |
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 $1,148.15 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,148.15 | $1,659.59 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,047.13 | $1,819.70 |
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 $707.95 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $288.40 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,071.52 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $213.80 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,096.48 | $1,096.48 |
Where Maryland sits
The same service costs 5.1 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
$1,259
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.