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 $3,548.13 Median $3,548.13 Typical High $3,630.78 | Professional | None | $3,548.13 | $3,548.13 | $3,630.78 |
CareFirst Setting Professional Modifier None Typical Low $3,019.95 Median $3,311.31 Typical High $4,073.80 | Professional | None | $3,019.95 | $3,311.31 | $4,073.80 |
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 $2,884.03 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,884.03 | $3,162.28 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,884.03 | $3,162.28 | $4,570.88 |
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 $2,398.83 Median $2,951.21 Typical High $5,888.44 | Professional | None | $2,398.83 | $2,951.21 | $5,888.44 |
Wellpoint Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,890.45 | Professional | None | $2,511.89 | $2,511.89 | $3,890.45 |
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 $1,778.28 Median $1,778.28 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | 53 · Discontinued | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,511.89 |
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
$3,236
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.