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 $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,412.54 | $1,445.44 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,513.56 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,073.80 Typical High $6,760.83 | Facility | None | $512.86 | $4,073.80 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,380.38 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,548.82 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,348.96 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,318.26 | $2,041.74 |
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 $707.95 Median $707.95 Typical High $724.44 | Professional | 52 · Reduced service | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,023.29 |
Where Maryland sits
The same service costs 24.5 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
$1,514
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.