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 $144.54 Median $338.84 Typical High $389.05 | Professional | None | $144.54 | $338.84 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | None | $144.54 | $162.18 | $162.18 |
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 $141.25 Median $309.03 Typical High $524.81 | Professional | None | $141.25 | $309.03 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $707.95 | Professional | None | $371.54 | $436.52 | $707.95 |
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 $117.49 Median $309.03 Typical High $676.08 | Professional | None | $117.49 | $309.03 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $616.60 | Professional | None | $363.08 | $363.08 | $616.60 |
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 $72.44 Median $97.72 Typical High $194.98 | Professional | 52 · Reduced service | $72.44 | $97.72 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.90 Typical High $77.62 | Professional | 53 · Discontinued | $28.84 | $38.90 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $144.54 Typical High $295.12 | Professional | 54 · Surgery only | $107.15 | $144.54 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $28.84 Typical High $58.88 | Professional | 55 · Aftercare only | $21.38 | $28.84 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.50 Typical High $38.90 | Professional | 56 · Pre-op care only | $14.45 | $19.50 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $134.90 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $100.00 | $134.90 | $275.42 |
Where Maryland sits
The same service costs 4.0 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· 37th of 51
$309
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.