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 $2,511.89 Median $2,511.89 Typical High $2,570.40 | Professional | None | $2,511.89 | $2,511.89 | $2,570.40 |
CareFirst Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,454.71 | $2,691.53 | $2,691.53 |
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 $2,290.87 Median $2,691.53 Typical High $6,456.54 | Professional | None | $2,290.87 | $2,691.53 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $4,365.16 | Professional | None | $2,570.40 | $2,884.03 | $4,365.16 |
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 $2,137.96 Median $3,235.94 Typical High $6,165.95 | Professional | None | $2,137.96 | $3,235.94 | $6,165.95 |
Wellpoint Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,137.96 | $3,801.89 |
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 $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,230.27 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $512.86 | Professional | 53 · Discontinued | $501.19 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,862.09 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,778.28 | $1,778.28 |
Where Maryland sits
The same service costs 8.1 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
$2,512
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.