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 $524.81 Median $537.03 Typical High $537.03 | Professional | None | $524.81 | $537.03 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | None | $537.03 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,630.78 Typical High $6,025.60 | Facility | None | $512.86 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $954.99 | Professional | None | $457.09 | $537.03 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $933.25 | Professional | None | $512.86 | $588.84 | $933.25 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,148.15 | Professional | None | $478.63 | $562.34 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $776.25 | Professional | None | $524.81 | $524.81 | $776.25 |
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 $263.03 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $380.19 |
Where Maryland sits
The same service costs 6.5 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· 44th of 51
$562
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.