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 $1,096.48 Median $1,122.02 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,122.02 | $2,290.87 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,318.26 | $1,412.54 |
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 $1,071.52 Median $1,318.26 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,318.26 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,318.26 | $2,089.30 |
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 $1,023.29 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,513.56 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,737.80 | Professional | None | $912.01 | $912.01 | $1,737.80 |
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 $537.03 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $537.03 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $776.25 |
Where Maryland sits
The same service costs 5.4 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
$1,202
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.