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 $933.25 Median $1,096.48 Typical High $1,288.25 | Professional | None | $933.25 | $1,096.48 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $933.25 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,000.00 | $4,466.84 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,995.26 | Professional | None | $851.14 | $1,096.48 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,548.82 | $2,344.23 |
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 $707.95 Median $1,023.29 Typical High $2,398.83 | Professional | None | $707.95 | $1,023.29 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $2,137.96 | Professional | None | $851.14 | $851.14 | $2,137.96 |
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 $467.74 Median $524.81 Typical High $645.65 | Professional | 52 · Reduced service | $467.74 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $263.03 | Professional | 53 · Discontinued | $186.21 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $707.95 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $194.98 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $912.01 |
Where Maryland sits
The same service costs 6.5 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· 46th of 51
$1,047
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.