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 $1,621.81 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,621.81 | $1,621.81 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,621.81 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $6,760.83 | Facility | None | $501.19 | $1,318.26 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,513.56 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,659.59 | $1,862.09 | $2,884.03 |
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 $1,148.15 Median $1,513.56 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,513.56 | $3,388.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,412.54 | $2,511.89 |
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 $812.83 Median $812.83 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | 53 · Discontinued | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,174.90 |
Where Maryland sits
The same service costs 18.6 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
$1,622
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.