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 $2,570.40 Typical High $2,570.40 | Professional | None | $2,511.89 | $2,570.40 | $2,570.40 |
CareFirst Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $2,818.38 | Professional | None | $2,511.89 | $2,754.23 | $2,818.38 |
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 $2,884.03 Typical High $6,309.57 | Professional | None | $2,290.87 | $2,884.03 | $6,309.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,630.27 | $2,951.21 | $4,466.84 |
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 $2,187.76 Median $3,235.94 Typical High $6,309.57 | Professional | None | $2,187.76 | $3,235.94 | $6,309.57 |
Wellpoint Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,890.45 | Professional | None | $2,187.76 | $2,187.76 | $3,890.45 |
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 $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,258.93 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $512.86 Typical High $524.81 | Professional | 53 · Discontinued | $501.19 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $251.19 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,819.70 |
Where Maryland sits
The same service costs 10.0 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
$2,512
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.