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 $1,949.84 Median $1,995.26 Typical High $2,041.74 | Professional | None | $1,949.84 | $1,995.26 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,819.70 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $5,011.87 | Facility | None | $512.86 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $4,786.30 | Professional | None | $1,698.24 | $2,137.96 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,698.24 | $1,995.26 | $3,311.31 |
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 $1,659.59 Median $2,454.71 Typical High $4,570.88 | Professional | None | $1,659.59 | $2,454.71 | $4,570.88 |
Wellpoint Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,659.59 | $1,659.59 | $2,630.27 |
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 $977.24 Median $1,000.00 Typical High $1,023.29 | Professional | 52 · Reduced service | $977.24 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $398.11 Typical High $407.38 | Professional | 53 · Discontinued | $389.05 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,445.44 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $288.40 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $199.53 Typical High $204.17 | Professional | 56 · Pre-op care only | $194.98 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,412.54 | $1,412.54 |
Where Maryland sits
The same service costs 6.9 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· 42nd of 51
$2,042
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.