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 $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,122.02 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,288.25 | $1,548.82 |
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 $1,047.13 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,202.26 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,202.26 | $1,737.80 |
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 $851.14 Median $1,096.48 Typical High $2,187.76 | Professional | None | $851.14 | $1,096.48 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,445.44 | Professional | None | $933.25 | $933.25 | $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 $549.54 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $549.54 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $831.76 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $831.76 |
Where Maryland sits
The same service costs 21.4 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· 36th of 51
$1,175
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.