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 $1,445.44 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,445.44 | $1,445.44 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $1,659.59 | Facility | None | $707.95 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,412.54 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,621.81 | $2,570.40 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $3,019.95 | Professional | None | $977.24 | $1,348.96 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,202.26 | $2,187.76 |
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 $724.44 Median $724.44 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,047.13 |
Where Maryland sits
The same service costs 17.0 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· 39th of 51
$1,445
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.