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 $1,445.44 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,621.81 | $3,235.94 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,479.11 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,090.30 Typical High $5,370.32 | Facility | None | $512.86 | $3,090.30 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $3,388.44 | Professional | None | $1,258.93 | $1,348.96 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,445.44 | $2,630.27 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $3,630.78 | Professional | None | $1,174.90 | $1,659.59 | $3,630.78 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,096.48 | $1,905.46 |
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 $741.31 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $323.59 Typical High $331.13 | Professional | 53 · Discontinued | $302.00 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,148.15 |
Where Maryland sits
The same service costs 4.4 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· 39th of 51
$1,622
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.