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 $208.93 Median $457.09 Typical High $630.96 | Professional | None | $208.93 | $457.09 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | None | $208.93 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $2,041.74 | Facility | None | $512.86 | $1,148.15 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $426.58 Typical High $707.95 | Professional | None | $194.98 | $426.58 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,148.15 | Professional | None | $630.96 | $741.31 | $1,148.15 |
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 $154.88 Median $338.84 Typical High $851.14 | Professional | None | $154.88 | $338.84 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $1,047.13 | Professional | None | $371.54 | $371.54 | $1,047.13 |
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 $104.71 Median $131.83 Typical High $316.23 | Professional | 52 · Reduced service | $104.71 | $131.83 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $52.48 Typical High $125.89 | Professional | 53 · Discontinued | $41.69 | $52.48 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $478.63 | Professional | 54 · Surgery only | $158.49 | $194.98 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $39.81 Typical High $95.50 | Professional | 55 · Aftercare only | $31.62 | $39.81 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.30 Typical High $63.10 | Professional | 56 · Pre-op care only | $20.89 | $26.30 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $181.97 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $147.91 | $181.97 | $446.68 |
Where Maryland sits
The same service costs 3.7 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· 50th of 51
$347
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.