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 $3,388.44 Median $3,467.37 Typical High $5,128.61 | Professional | None | $3,388.44 | $3,467.37 | $5,128.61 |
CareFirst Setting Professional Modifier None Typical Low $3,311.31 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,311.31 | $3,630.78 | $3,630.78 |
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 $3,090.30 Median $3,981.07 Typical High $8,709.64 | Professional | None | $3,090.30 | $3,981.07 | $8,709.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $6,025.60 | Professional | None | $3,388.44 | $3,801.89 | $6,025.60 |
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 $2,951.21 Median $4,466.84 Typical High $8,511.38 | Professional | None | $2,951.21 | $4,466.84 | $8,511.38 |
Wellpoint Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $5,011.87 | Professional | None | $3,019.95 | $3,019.95 | $5,011.87 |
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 $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,698.24 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $676.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,570.40 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,511.89 | $2,570.40 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $512.86 Typical High $524.81 | Professional | 55 · Aftercare only | $501.19 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,398.83 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,398.83 | $2,454.71 |
Where Maryland sits
The same service costs 7.2 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
$3,388
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.