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 $4,365.16 Median $4,466.84 Typical High $4,570.88 | Professional | None | $4,365.16 | $4,466.84 | $4,570.88 |
CareFirst Setting Professional Modifier None Typical Low $3,981.07 Median $4,466.84 Typical High $5,248.07 | Professional | None | $3,981.07 | $4,466.84 | $5,248.07 |
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 $3,467.37 Median $3,981.07 Typical High $5,888.44 | Professional | None | $3,467.37 | $3,981.07 | $5,888.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $3,981.07 Typical High $5,754.40 | Professional | None | $3,630.78 | $3,981.07 | $5,754.40 |
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 $2,951.21 Median $3,715.35 Typical High $7,244.36 | Professional | None | $2,951.21 | $3,715.35 | $7,244.36 |
Wellpoint Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,884.03 | $2,884.03 | $4,897.79 |
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 $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $2,238.72 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $891.25 Typical High $912.01 | Professional | 53 · Discontinued | $891.25 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $3,388.44 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $446.68 Typical High $457.09 | Professional | 56 · Pre-op care only | $446.68 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,090.30 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,090.30 | $3,162.28 |
Where Maryland sits
The same service costs 21.9 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· 35th of 51
$4,074
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.