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 $338.84 Median $489.78 Typical High $524.81 | Professional | None | $338.84 | $489.78 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | None | $316.23 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,258.93 Typical High $2,187.76 | Facility | None | $446.68 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $758.58 | Professional | None | $309.03 | $436.52 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $954.99 | Professional | None | $549.54 | $616.60 | $954.99 |
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 $251.19 Median $389.05 Typical High $870.96 | Professional | None | $251.19 | $389.05 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $851.14 | Professional | None | $295.12 | $295.12 | $851.14 |
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 $169.82 Median $194.98 Typical High $263.03 | Professional | 52 · Reduced service | $169.82 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $77.62 Typical High $104.71 | Professional | 53 · Discontinued | $67.61 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $295.12 Typical High $398.11 | Professional | 54 · Surgery only | $251.19 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $58.88 Typical High $79.43 | Professional | 55 · Aftercare only | $50.12 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.88 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $275.42 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $234.42 | $275.42 | $371.54 |
Where Maryland sits
The same service costs 4.8 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· 46th of 51
$389
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.