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 $407.38 Median $1,258.93 Typical High $1,584.89 | Professional | None | $407.38 | $1,258.93 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $645.65 | Professional | None | $380.19 | $416.87 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,202.26 Typical High $2,187.76 | Facility | None | $512.86 | $1,202.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,230.27 Typical High $3,090.30 | Professional | None | $398.11 | $1,230.27 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,778.28 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $5,754.40 | Facility | None | $1,348.96 | $2,570.40 | $5,754.40 |
United Setting Professional Modifier None Typical Low $416.87 Median $1,348.96 Typical High $3,715.35 | Professional | None | $416.87 | $1,348.96 | $3,715.35 |
Wellpoint Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,380.38 | $2,344.23 |
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 $204.17 Median $630.96 Typical High $794.33 | Professional | 52 · Reduced service | $204.17 | $630.96 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $251.19 Typical High $316.23 | Professional | 53 · Discontinued | $83.18 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $933.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $309.03 | $933.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $186.21 Typical High $239.88 | Professional | 55 · Aftercare only | $61.66 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $125.89 Typical High $158.49 | Professional | 56 · Pre-op care only | $40.74 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $870.96 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $288.40 | $870.96 | $1,122.02 |
Where Maryland sits
The same service costs 4.9 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· 42nd of 51
$1,288
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.