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 $1,995.26 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,995.26 | $1,995.26 | $2,089.30 |
CareFirst Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,238.72 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $9,332.54 Typical High $15,488.17 | Facility | None | $512.86 | $9,332.54 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,737.80 | $1,995.26 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $3,548.13 | Professional | None | $2,041.74 | $2,290.87 | $3,548.13 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $4,265.80 | Professional | None | $1,412.54 | $1,862.09 | $4,265.80 |
Wellpoint Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,737.80 | $1,737.80 | $3,162.28 |
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 $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | 53 · Discontinued | $398.11 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $309.03 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,445.44 |
Where Maryland sits
The same service costs 16.2 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· 36th of 51
$2,239
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.