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 $676.08 Median $676.08 Typical High $724.44 | Professional | None | $676.08 | $676.08 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | None | $676.08 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,019.95 Typical High $5,128.61 | Facility | None | $630.96 | $3,019.95 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,202.26 | Professional | None | $588.84 | $691.83 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,230.27 | Professional | None | $660.69 | $758.58 | $1,230.27 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,412.54 | Professional | None | $575.44 | $691.83 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,023.29 | Professional | None | $660.69 | $660.69 | $1,023.29 |
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 $338.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $501.19 |
Where Maryland sits
The same service costs 8.1 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· 41st of 51
$724
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.