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 $3,019.95 Median $3,090.30 Typical High $3,235.94 | Professional | None | $3,019.95 | $3,090.30 | $3,235.94 |
CareFirst Setting Professional Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $3,162.28 | Professional | None | $2,818.38 | $3,090.30 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $7,244.36 | Professional | None | $2,511.89 | $3,162.28 | $7,244.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,818.38 | $3,162.28 | $4,897.79 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $7,079.46 | Professional | None | $2,344.23 | $3,630.78 | $7,079.46 |
Wellpoint Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $4,168.69 | Professional | None | $2,238.72 | $2,238.72 | $4,168.69 |
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 $1,479.11 Median $1,513.56 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,479.11 | $1,513.56 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $602.56 Typical High $645.65 | Professional | 53 · Discontinued | $588.84 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,290.87 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,238.72 | $2,290.87 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $457.09 Typical High $489.78 | Professional | 55 · Aftercare only | $446.68 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $302.00 Typical High $323.59 | Professional | 56 · Pre-op care only | $295.12 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,137.96 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,137.96 | $2,290.87 |
Where Maryland sits
The same service costs 8.3 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· 38th of 51
$2,818
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.