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 $660.69 Median $676.08 Typical High $691.83 | Professional | None | $660.69 | $676.08 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | None | $691.83 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,630.78 Typical High $6,025.60 | Facility | None | $630.96 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,202.26 | Professional | None | $616.60 | $707.95 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,174.90 | Professional | None | $691.83 | $794.33 | $1,174.90 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,445.44 | Professional | None | $524.81 | $660.69 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,071.52 | Professional | None | $660.69 | $660.69 | $1,071.52 |
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 $331.13 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $131.83 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $501.19 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $489.78 |
Where Maryland sits
The same service costs 7.2 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· 43rd of 51
$692
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.