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 $1,513.56 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,513.56 | $1,548.82 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,479.11 | $1,698.24 |
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 $1,288.25 Median $1,548.82 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,548.82 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,584.89 | $2,630.27 |
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 $1,230.27 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,819.70 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,230.27 | $2,089.30 |
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 $741.31 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $741.31 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $295.12 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $234.42 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,096.48 |
Where Maryland sits
The same service costs 6.3 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· 42nd of 51
$1,549
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.