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 $1,995.26 Median $1,995.26 Typical High $2,041.74 | Professional | None | $1,995.26 | $1,995.26 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,905.46 | $2,290.87 |
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 $1,584.89 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,584.89 | $1,819.70 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,621.81 | $1,778.28 | $2,630.27 |
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 $1,288.25 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,288.25 | $1,659.59 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,445.44 | $2,187.76 |
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 $1,000.00 Median $1,000.00 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 53 · Discontinued | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $309.03 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,445.44 |
Where Maryland sits
The same service costs 4.9 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
$1,820
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.