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 $1,148.15 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,174.90 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,019.95 Typical High $5,011.87 | Facility | None | $630.96 | $3,019.95 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,754.23 | Professional | None | $977.24 | $1,230.27 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,862.09 | Professional | None | $954.99 | $1,096.48 | $1,862.09 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $2,691.53 | Professional | None | $954.99 | $1,412.54 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,445.44 | Professional | None | $870.96 | $870.96 | $1,445.44 |
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 $575.44 Median $588.84 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $891.25 |
Where Maryland sits
The same service costs 6.8 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· 41st of 51
$1,230
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.