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 $1,737.80 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,737.80 | $1,778.28 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,862.09 | $1,949.84 |
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 $1,905.46 Typical High $4,897.79 | Professional | None | $1,584.89 | $1,905.46 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,778.28 | $2,884.03 |
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 $1,479.11 Median $2,187.76 Typical High $4,073.80 | Professional | None | $1,479.11 | $2,187.76 | $4,073.80 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,318.26 | $2,290.87 |
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 $870.96 Median $870.96 Typical High $891.25 | Professional | 52 · Reduced service | $870.96 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,230.27 |
Where Maryland sits
The same service costs 6.9 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· 40th of 51
$1,698
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.