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 $1,479.11 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,479.11 | $1,513.56 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,548.82 | $1,819.70 |
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 $1,348.96 Median $1,621.81 Typical High $4,168.69 | Professional | None | $1,348.96 | $1,621.81 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,479.11 | $2,398.83 |
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 $1,230.27 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,230.27 | $1,819.70 | $3,388.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,096.48 | $1,949.84 |
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 $724.44 Median $724.44 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $302.00 | Professional | 53 · Discontinued | $295.12 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,047.13 |
Where Maryland sits
The same service costs 5.5 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· 44th of 51
$1,445
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.