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 $1,621.81 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,621.81 | $1,698.24 | $1,737.80 |
CareFirst Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,479.11 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,000.00 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $4,073.80 | Professional | None | $1,412.54 | $1,698.24 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,778.28 | $2,818.38 |
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 $1,348.96 Median $2,041.74 Typical High $3,890.45 | Professional | None | $1,348.96 | $2,041.74 | $3,890.45 |
Wellpoint Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,380.38 | $2,344.23 |
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 $812.83 Median $851.14 Typical High $870.96 | Professional | 52 · Reduced service | $812.83 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $346.74 | Professional | 53 · Discontinued | $323.59 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $263.03 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,230.27 |
Where Maryland sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 41st of 51
$1,738
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.