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 $2,454.71 Median $2,951.21 Typical High $6,025.60 | Professional | None | $2,454.71 | $2,951.21 | $6,025.60 |
CareFirst Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,818.38 | $2,818.38 |
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 $2,238.72 Median $2,754.23 Typical High $6,165.95 | Professional | None | $2,238.72 | $2,754.23 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $4,897.79 | Professional | None | $2,344.23 | $2,691.53 | $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 $2,137.96 Median $2,951.21 Typical High $6,606.93 | Professional | None | $2,137.96 | $2,951.21 | $6,606.93 |
Wellpoint Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,949.84 | $1,949.84 | $3,548.13 |
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 $1,380.38 Median $1,479.11 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,380.38 | $1,479.11 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $588.84 Typical High $602.56 | Professional | 53 · Discontinued | $549.54 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,041.74 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $295.12 Typical High $302.00 | Professional | 56 · Pre-op care only | $275.42 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,089.30 | $2,089.30 |
Where Maryland sits
The same service costs 5.9 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· 40th of 51
$2,570
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.