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 $1,288.25 Median $1,380.38 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,380.38 | $1,412.54 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,258.93 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,235.94 Typical High $5,754.40 | Facility | None | $512.86 | $3,235.94 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $2,951.21 | Professional | None | $1,071.52 | $1,148.15 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,230.27 | $2,238.72 |
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 $1,047.13 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,047.13 | $1,479.11 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,621.81 | Professional | None | $933.25 | $933.25 | $1,621.81 |
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 $645.65 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $645.65 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $141.25 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $977.24 |
Where Maryland sits
The same service costs 4.8 times more in Wisconsin 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
$1,479
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.