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 $794.33 Median $831.76 Typical High $831.76 | Professional | None | $794.33 | $831.76 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | None | $776.25 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,000.00 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,445.44 | Professional | None | $707.95 | $794.33 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,412.54 | Professional | None | $741.31 | $851.14 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,698.24 | Professional | None | $588.84 | $758.58 | $1,698.24 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,148.15 | Professional | None | $707.95 | $707.95 | $1,148.15 |
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 $398.11 Median $398.11 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 53 · Discontinued | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $588.84 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $588.84 |
Where Maryland sits
The same service costs 7.9 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· 41st of 51
$832
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.