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 $3,235.94 Median $3,311.31 Typical High $3,630.78 | Professional | None | $3,235.94 | $3,311.31 | $3,630.78 |
CareFirst Setting Professional Modifier None Typical Low $3,162.28 Median $3,467.37 Typical High $3,630.78 | Professional | None | $3,162.28 | $3,467.37 | $3,630.78 |
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 $2,951.21 Median $3,801.89 Typical High $8,317.64 | Professional | None | $2,951.21 | $3,801.89 | $8,317.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $5,623.41 | Professional | None | $3,235.94 | $3,630.78 | $5,623.41 |
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 $2,884.03 Median $4,265.80 Typical High $7,943.28 | Professional | None | $2,884.03 | $4,265.80 | $7,943.28 |
Wellpoint Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,786.30 | Professional | None | $2,951.21 | $2,951.21 | $4,786.30 |
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 $1,584.89 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,584.89 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $660.69 | Professional | 53 · Discontinued | $645.65 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,398.83 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,290.87 | $2,290.87 |
Where Maryland sits
The same service costs 7.8 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· 39th of 51
$3,236
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.