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 $2,630.27 Median $2,630.27 Typical High $2,691.53 | Professional | None | $2,630.27 | $2,630.27 | $2,691.53 |
CareFirst Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,570.40 | $2,884.03 | $2,884.03 |
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 $2,398.83 Median $3,162.28 Typical High $6,760.83 | Professional | None | $2,398.83 | $3,162.28 | $6,760.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $4,570.88 | Professional | None | $2,691.53 | $3,019.95 | $4,570.88 |
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 $2,290.87 Median $3,467.37 Typical High $6,456.54 | Professional | None | $2,290.87 | $3,467.37 | $6,456.54 |
Wellpoint Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,981.07 | Professional | None | $2,398.83 | $2,398.83 | $3,981.07 |
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 $1,318.26 Median $1,318.26 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 53 · Discontinued | $524.81 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,949.84 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,862.09 | $1,862.09 |
Where Maryland sits
The same service costs 17.0 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· 40th of 51
$2,630
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.