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 $363.08 Median $389.05 Typical High $478.63 | Professional | None | $363.08 | $389.05 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | None | $371.54 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $436.52 | Facility | None | $125.89 | $204.17 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $691.83 | Professional | None | $323.59 | $380.19 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $794.33 | Professional | None | $457.09 | $524.81 | $794.33 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $812.83 | Professional | None | $257.04 | $338.84 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $724.44 | Professional | None | $338.84 | $338.84 | $724.44 |
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 $181.97 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $316.23 | Professional | 54 · Surgery only | $269.15 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $63.10 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $295.12 |
Where Maryland sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$380
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.