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 $1,905.46 Median $2,041.74 Typical High $2,089.30 | Professional | None | $1,905.46 | $2,041.74 | $2,089.30 |
CareFirst Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,949.84 | $2,344.23 |
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 $1,659.59 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,659.59 | $1,819.70 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,659.59 | $1,819.70 | $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 $1,412.54 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,412.54 | $1,698.24 | $3,388.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,479.11 | $2,238.72 |
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 $1,023.29 Median $1,023.29 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 53 · Discontinued | $407.38 | $407.38 | $416.87 |
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 $204.17 Median $204.17 Typical High $208.93 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $208.93 |
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 4.6 times more in Wyoming than in Utah. 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· 43rd 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.