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 $2,570.40 Median $2,691.53 Typical High $2,754.23 | Professional | None | $2,570.40 | $2,691.53 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,630.27 | $2,951.21 | $2,951.21 |
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 $2,454.71 Median $2,884.03 Typical High $6,918.31 | Professional | None | $2,454.71 | $2,884.03 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $3,090.30 Typical High $4,786.30 | Professional | None | $2,754.23 | $3,090.30 | $4,786.30 |
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 $6,606.93 | Professional | None | $2,290.87 | $3,467.37 | $6,606.93 |
Wellpoint Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $4,073.80 | Professional | None | $2,290.87 | $2,290.87 | $4,073.80 |
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 $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,348.96 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,041.74 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,995.26 | $2,041.74 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,905.46 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,905.46 | $1,949.84 |
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· 38th of 51
$2,692
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.