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 $2,344.23 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,454.71 | $2,884.03 |
CareFirst Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,344.23 | $2,630.27 | $2,630.27 |
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 $2,137.96 Median $2,818.38 Typical High $6,309.57 | Professional | None | $2,137.96 | $2,818.38 | $6,309.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $4,265.80 | Professional | None | $2,344.23 | $2,691.53 | $4,265.80 |
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 $2,089.30 Median $3,090.30 Typical High $5,888.44 | Professional | None | $2,089.30 | $3,090.30 | $5,888.44 |
Wellpoint Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,187.76 | $3,548.13 |
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 $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,174.90 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,778.28 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $354.81 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,737.80 | $1,737.80 |
Where Maryland sits
The same service costs 6.0 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· 46th of 51
$2,344
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.