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 $3,715.35 Median $3,890.45 Typical High $7,413.10 | Professional | None | $3,715.35 | $3,890.45 | $7,413.10 |
CareFirst Setting Professional Modifier None Typical Low $3,715.35 Median $4,073.80 Typical High $4,365.16 | Professional | None | $3,715.35 | $4,073.80 | $4,365.16 |
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 $3,467.37 Median $4,570.88 Typical High $9,772.37 | Professional | None | $3,467.37 | $4,570.88 | $9,772.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,801.89 Median $4,265.80 Typical High $6,606.93 | Professional | None | $3,801.89 | $4,265.80 | $6,606.93 |
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 $3,388.44 Median $5,011.87 Typical High $9,332.54 | Professional | None | $3,388.44 | $5,011.87 | $9,332.54 |
Wellpoint Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $5,623.41 | Professional | None | $3,548.13 | $3,548.13 | $5,623.41 |
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 $1,862.09 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,862.09 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 53 · Discontinued | $758.58 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,818.38 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $562.34 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $380.19 Typical High $389.05 | Professional | 56 · Pre-op care only | $371.54 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,691.53 | $2,691.53 |
Where Maryland sits
The same service costs 7.6 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
$3,715
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.