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 $602.56 Median $776.25 Typical High $933.25 | Professional | None | $602.56 | $776.25 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $2,041.74 | Facility | None | $446.68 | $1,148.15 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,096.48 | Professional | None | $575.44 | $724.44 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,584.89 | Professional | None | $831.76 | $954.99 | $1,584.89 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,548.82 | Professional | None | $524.81 | $741.31 | $1,548.82 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,288.25 | Professional | None | $616.60 | $616.60 | $1,288.25 |
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 $302.00 Median $309.03 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $562.34 |
Where Maryland sits
The same service costs 4.2 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· 44th of 51
$676
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.