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 $1,096.48 Median $1,096.48 Typical High $1,122.02 | Professional | None | $1,096.48 | $1,096.48 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $13,803.84 Typical High $25,118.86 | Facility | None | $512.86 | $13,803.84 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,949.84 | Professional | None | $912.01 | $1,071.52 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,202.26 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $2,137.96 | Professional | None | $831.76 | $977.24 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,000.00 | $1,621.81 |
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 $549.54 Median $549.54 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | 53 · Discontinued | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $794.33 |
Where Maryland sits
The same service costs 5.9 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· 35th of 51
$1,202
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.