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 $1,318.26 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,412.54 | $1,479.11 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,380.38 | $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 $1,230.27 Median $1,513.56 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,513.56 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,445.44 | $2,398.83 |
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 $1,174.90 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,174.90 | $1,737.80 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,174.90 | $1,905.46 |
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 $691.83 Median $724.44 Typical High $741.31 | Professional | 52 · Reduced service | $691.83 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $281.84 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $223.87 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,047.13 |
Where Maryland sits
The same service costs 6.5 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· 43rd of 51
$1,479
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.