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 Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $562.34 | Facility | None | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $302.00 | Professional | None | $223.87 | $275.42 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $239.88 | Professional | None | $218.78 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $758.58 Typical High $1,348.96 | Facility | None | $331.13 | $758.58 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $407.38 | Professional | None | $218.78 | $269.15 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $575.44 | Professional | None | $302.00 | $338.84 | $575.44 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $575.44 | Professional | None | $190.55 | $269.15 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $467.74 | Professional | None | $223.87 | $223.87 | $467.74 |
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 $112.20 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $112.20 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $44.67 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | 54 · Surgery only | $169.82 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $204.17 |
Where Maryland sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 40th of 51
$275
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.