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 $2,137.96 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,137.96 | $2,290.87 | $2,290.87 |
CareFirst Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,862.09 | $2,089.30 | $2,089.30 |
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 $1,737.80 Median $2,137.96 Typical High $4,897.79 | Professional | None | $1,737.80 | $2,137.96 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,778.28 | $1,995.26 | $3,715.35 |
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 $1,737.80 Median $2,454.71 Typical High $5,128.61 | Professional | None | $1,737.80 | $2,454.71 | $5,128.61 |
Wellpoint Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,548.82 | $2,691.53 |
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 $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,071.52 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,621.81 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $213.80 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,621.81 | $1,621.81 |
Where Maryland sits
The same service costs 5.8 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· 45th of 51
$1,862
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.