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 $1,071.52 Median $1,096.48 Typical High $1,122.02 | Professional | None | $1,071.52 | $1,096.48 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $9,549.93 Typical High $15,488.17 | Facility | None | $512.86 | $9,549.93 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,949.84 | Professional | None | $954.99 | $1,071.52 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,621.81 | $2,187.76 |
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 $1,023.29 Typical High $2,290.87 | Professional | None | $831.76 | $1,023.29 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,023.29 | $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 $537.03 Median $537.03 Typical High $562.34 | Professional | 52 · Reduced service | $537.03 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $776.25 |
Where Maryland sits
The same service costs 6.3 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· 43rd of 51
$1,122
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.