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 $1,479.11 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,584.89 | $1,778.28 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,513.56 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,691.53 Typical High $4,466.84 | Facility | None | $512.86 | $2,691.53 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $4,265.80 | Professional | None | $1,380.38 | $1,659.59 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,513.56 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,258.93 | $1,905.46 | $3,801.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,122.02 | $1,995.26 |
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 $724.44 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $724.44 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,122.02 |
Where Maryland sits
The same service costs 5.8 times more in Alaska 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· 45th of 51
$1,585
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.