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 $1,659.59 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,659.59 | $1,698.24 | $3,162.28 |
CareFirst Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,344.23 | Professional | None | $2,041.74 | $2,290.87 | $2,344.23 |
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 $1,819.70 Median $2,290.87 Typical High $5,128.61 | Professional | None | $1,819.70 | $2,290.87 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,238.72 | $3,467.37 |
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 $1,737.80 Median $2,630.27 Typical High $5,011.87 | Professional | None | $1,737.80 | $2,630.27 | $5,011.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,819.70 | $1,819.70 | $2,951.21 |
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 $831.76 Median $851.14 Typical High $933.25 | Professional | 52 · Reduced service | $831.76 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $186.21 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,318.26 |
Where Maryland sits
The same service costs 7.2 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· 41st of 51
$2,042
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.