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 $1,513.56 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,548.82 | $2,344.23 |
CareFirst Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,187.76 | Professional | None | $1,862.09 | $2,089.30 | $2,187.76 |
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 $1,659.59 Median $2,089.30 Typical High $4,677.35 | Professional | None | $1,659.59 | $2,089.30 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,778.28 | $2,041.74 | $3,162.28 |
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 $1,584.89 Median $2,398.83 Typical High $4,466.84 | Professional | None | $1,584.89 | $2,398.83 | $4,466.84 |
Wellpoint Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,659.59 | $1,659.59 | $2,691.53 |
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 $758.58 Median $776.25 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $154.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,202.26 |
Where Maryland sits
The same service costs 6.0 times more in Alaska than in Utah. 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
$1,862
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.