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 $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,380.38 | $1,513.56 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,479.11 | $1,659.59 |
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 $1,122.02 Median $1,380.38 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,380.38 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,318.26 | $2,398.83 |
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 $1,122.02 Median $1,584.89 Typical High $3,388.44 | Professional | None | $1,122.02 | $1,584.89 | $3,388.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,000.00 | $1,737.80 |
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 $691.83 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $691.83 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $275.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,047.13 |
Where Maryland sits
The same service costs 5.4 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
$1,318
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.