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 $1,778.28 Median $1,778.28 Typical High $1,819.70 | Professional | None | $1,778.28 | $1,778.28 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,698.24 | $2,041.74 |
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 $1,412.54 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,584.89 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,584.89 | $2,290.87 |
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 $1,202.26 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,479.11 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,258.93 | $1,949.84 |
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 $891.25 Median $891.25 Typical High $912.01 | Professional | 52 · Reduced service | $891.25 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,258.93 |
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· 38th 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.