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 $478.63 Median $489.78 Typical High $501.19 | Professional | None | $478.63 | $489.78 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | None | $467.74 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $794.33 | Facility | None | $380.19 | $501.19 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $870.96 | Professional | None | $426.58 | $489.78 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $851.14 | Professional | None | $489.78 | $562.34 | $851.14 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $1,000.00 | Professional | None | $331.13 | $446.68 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $758.58 | Professional | None | $407.38 | $407.38 | $758.58 |
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 $239.88 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $239.88 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $354.81 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $354.81 |
Where Maryland sits
The same service costs 6.9 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· 38th of 51
$479
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.