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 $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,348.96 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,715.35 Typical High $6,025.60 | Facility | None | $707.95 | $3,715.35 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,288.25 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,412.54 | $2,290.87 |
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 $1,000.00 Median $1,230.27 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,230.27 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,230.27 | $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 $630.96 Median $630.96 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $933.25 |
Where Maryland sits
The same service costs 7.9 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
$1,318
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.