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 $812.83 Median $3,162.28 Typical High $7,244.36 | Professional | None | $812.83 | $3,162.28 | $7,244.36 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,047.13 | Professional | None | $741.31 | $831.76 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $7,244.36 Typical High $12,022.64 | Facility | None | $1,288.25 | $7,244.36 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $2,754.23 Typical High $10,471.29 | Professional | None | $794.33 | $2,754.23 | $10,471.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,370.32 Median $7,244.36 Typical High $12,022.64 | Professional | None | $5,370.32 | $7,244.36 | $12,022.64 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,413.10 Typical High $9,332.54 | Facility | None | $3,019.95 | $7,413.10 | $9,332.54 |
United Setting Professional Modifier None Typical Low $776.25 Median $2,041.74 Typical High $12,589.25 | Professional | None | $776.25 | $2,041.74 | $12,589.25 |
Wellpoint Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $9,549.93 | Professional | None | $5,623.41 | $5,623.41 | $9,549.93 |
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 $407.38 Median $724.44 Typical High $3,630.78 | Professional | 52 · Reduced service | $407.38 | $724.44 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $288.40 Typical High $1,445.44 | Professional | 53 · Discontinued | $162.18 | $288.40 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $1,096.48 Typical High $5,370.32 | Professional | 54 · Surgery only | $602.56 | $1,096.48 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $218.78 Typical High $1,071.52 | Professional | 55 · Aftercare only | $120.23 | $218.78 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $144.54 Typical High $724.44 | Professional | 56 · Pre-op care only | $81.28 | $144.54 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $1,023.29 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $562.34 | $1,023.29 | $5,011.87 |
Where Maryland sits
The same service costs 7.9 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· 29th of 51
$4,571
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.